CT引导下腰交感神经射频热凝术治疗糖尿病周围神经病变的效果及安全性  

Effect and Safety of CT Guided Radiofrequency Thermocoagulation of Lumbar Sympathetic Nerve in Treatment of Diabetes Peripheral Neuropathy

作　　者：沈琳 金星 郑威 何巍[1] SHEN Lin;JIN Xing;ZHENG Wei;HE Wei(Affiliated Hospital of Beihua University,Jilin 132011,China)

机构地区：[1]北华大学附属医院,吉林吉林132011

出　　处：《北华大学学报（自然科学版）》2024年第4期482-487,共6页Journal of Beihua University（Natural Science）

基　　金：吉林省教育厅科学技术研究项目(JJKH20210060KJ)。

摘　　要：目的 探讨CT引导下腰交感神经射频热凝术治疗糖尿病周围神经病变(DPN)的效果,并分析其安全性。方法 将100例DPN患者随机分为对照组和研究组,每组50例,对照组给予CT引导下化学毁损术,研究组给予CT引导下腰交感神经射频热凝术治疗。比较两组患者临床治疗效果,包括治疗前、治疗后7 d、治疗后30 d、治疗后90 d疼痛情况,治疗前、治疗后30 min、治疗后1 d、治疗后3 d皮肤温度,治疗前、治疗后90 d症状评分、神经传导速度及并发症发生情况。结果 研究组患者临床治疗效果优于对照组,且治疗总有效率为88.00%,明显高于对照组的70.00%(P<0.05)。治疗后7、30、90 d两组患者视觉模拟评分法(VAS)评分较治疗前均降低(P<0.05),且研究组患者VAS评分明显低于对照组(P<0.05);治疗后30 min、1 d、3 d研究组患者皮肤温度较治疗前均升高(P<0.05),治疗后3 d对照组患者皮肤温度较治疗前升高(P<0.05),治疗后30 min、1 d、3 d研究组患者皮肤温度明显高于对照组(P<0.05);治疗后90 d两组患者密歇根糖尿病性周围神经病评分(MDNS)、神经系统症状评分(NSS)较治疗前均降低(P<0.05),且研究组患者MDNS、NSS评分明显低于对照组(P<0.05);治疗后90 d两组患者正中神经、腓总神经的感觉神经传导速度(SNCV)、运动神经传导速度(MNCV)较治疗前均升高(P<0.05),且研究组患者正中神经、腓总神经的SNCV、MNCV明显高于对照组(P<0.05);研究组患者并发症发生率为0,明显低于对照组的16.00%(P<0.05)。结论 CT引导下腰交感神经射频热凝术治疗DPN可有效减轻疼痛,改善皮肤温度和症状,提高神经传导速度,且安全性高。Objective To investigate the efficacy and safety of CT guided radiofrequency thermocoagulation of lumbar sympathetic nerve in the treatment of diabetes peripheral neuropathy(DPN).Method 100 DPN pati-ents were randomly divided into two groups:a control group of 50 cases and a study group of 50 cases.The control group received CT guided chemical ablation,while the study group received CT guided lumbar sympathetic nerve radiofrequency thermocoagulation.Compare the clinical treatment efficacy of two groups,including pain before treatment,7 days after treatment,30 days after treatment,90 days after treatment,skin temperature before treatment,30 minutes after treatment,1 day after treatment,3 days after treatment,symptom scores before and 90 days after treatment,nerve conduction velocity and incidence of complications.Results The clinical treatment efficacy of the study group was better than that of the control group,and the total effective rate of the study group was 88.00%,significantly higher than 70.00%of the control group(P<0.05).On the 7th,30th and 90th days after treatment,the visual analogue scale(VAS)scores of both groups decreased comparing to before treatment(P<0.05),and the VAS scores of the study group were significantly lower than those of the control group(P<0.05).The skin temperature of the study group increased 30 minutes,1 day,and 3 days after treatment comparing to before treatment(P<0.05).The skin temperature of the study group was significantly higher than that of the control group 30 minutes,1 day and 3 days after treatment(P<0.05).90 days after treatment,the scores of Michigan diabetes peripheral neuropathy(MDNS)and nervous system symptom score(NSS)in the two groups were lower than those before treatment(P<0.05),and the scores of MDNS and NSS in the study group were significantly lower than those in the control group(P<0.05).The sensory nerve conduction velocity(SNCV)and motor nerve conduction velocity(MNCV)of median nerve and common peroneal nerve in the two groups increased 90 days after treatm

关 键 词：CT 腰交感神经射频热凝术 糖尿病周围神经病 治疗效果 皮肤温度 症状评分 神经传导速度 并发症 

分 类 号：R587.2[医药卫生—内分泌]