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目的探讨显微手术进行神经松解减压对糖尿病周围神经病的疗效。方法对30例糖尿病周围神经病人进行双下肢神经松解,在显微镜下分别在内踝管胫神经及其分支、膝外侧腓神经管腓总神经、足背腓深神经处用显微外科技术分别减压受压神经及切开松解神经外膜、束膜。观察病人手术前及术后足部麻木、疼痛症状缓解程度,两点辨别觉,足底欧米诺试验,检查上述神经感觉及运动传导速度。结果术后患者麻木、疼痛症状明显缓解有效率分别为93.33%、96.67%,足底欧米诺试验阳性为90.00%,腓总神经、胫神经感觉及运动神经传导速度明显加快(P均<0.01),两点辨别觉明显改善(P<0.01)。结论糖尿病周围神经病经过在显微外科手术下进行神经管道性狭窄松解及神经外膜、束膜的松解后能明显缓解病人的麻木、疼痛症状,神经功能有一定的恢复。
Objective To investigate the effect of microsurgical decompression on diabetic peripheral neuropathy. Methods Thirty patients with diabetic peripheral neuropathy were subjected to bilateral lower extremity neurolysis. Microsurgery was performed on the tibial nerve of the medial malleolus and its branches, the common peroneal nerve common peroneal nerve and the deep dorsal peroneal nerve respectively by microsurgical technique Press the nerve compression and incision release of the epineurium, fascia. Observed before and after the operation of patients with numbness of the foot, the degree of pain relief, two-point discrimination, foot Omomino test to check the nerve sensory and motor conduction velocity. Results The postoperative numbness and pain relief were 93.33% and 96.67%, respectively. The positive rate of Omnivore soleus test was 90.00%. The sensation of common peroneal nerve and tibial nerve and motor nerve conduction velocity were significantly increased (all P <0.01) , Two-point discrimination was significantly improved (P <0.01). Conclusions Diabetic peripheral neuropathy can relieve numbness, pain symptoms and neurological function of patients with neuropathic pain after neurosurgical stenosis and neurofilament release under the condition of microsurgery.