血糖控制情况对糖尿病周围神经病变(DPN)患者下肢神经减压术疗效的影响

Effects of glycemic control on the therapeutic efficacy of lower limb nerve decompression in patients with diabetic peripheral neuropathy (DPN)

目的探讨糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)患者的血糖控制情况对周围神经减压手术疗效的影响。方法 2014年12月至2016年6月在复旦大学附属中山医院接受单侧下肢神经减压术的DPN患者共计40例,以HbA1c=8%为标准分为血糖控制尚可组和血糖控制不佳组。在术前1天和术后6个月,测量视觉模拟评分(visual analogue scale,VAS)、两点辨别觉(two point discrimination,TPD)和10 g单丝测验,比较两组患者的手术疗效。结果所有患者术后VAS、TPD和10 g单丝测验结果均较术前均明显改善。血糖控制尚可的患者术后VAS、TPD和10 g单丝测验结果均优于血糖控制不佳的患者。结论良好的血糖控制对DPN患者下肢神经减压术后疼痛的缓解和肢体感觉的恢复具有积极作用,血糖控制尚可的患者手术疗效明显优于血糖控制不佳的患者。

Objective To investigate the role of glycemic control in patients with diabetic peripheral neuropathy(DPN)on the curative effect of peripheral nerve decompression.Methods A total of 40 DPN patients who were operated with lower limb nerve decompression in Zhongshan Hospital,Fudan University during Dec.,2014 and Jun.,2016 were divided into ordinary glycemic control group and poor glycemic control group using a standard of HbA1c=8%.At the time point of 1 day before and 6 months after surgery,visual analogue scale(VAS),two point discrimination(TPD)and 10 g-monofilament examination were performed and compared between the two groups to evaluate curative effect.Results VAS,TPD and 10 g-monofilament examination of all patients were significantly improved after the surgery.The postoperative results of VAS,TPD and 10 g-monofilament examination of ordinary glycemic control group were better than those of the poor glycemic control group.Conclusions Optimal glycemic control has a positive effect on pain relief and recovery of limb sensation in patients with DPN after peripheral nerve decompression.The curative effect of patients with ordinary glycemic control is significantly better than those with poor glycemic control after the surgery.