显微手术进行糖尿病周围神经病神经松解30例

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。

Microsurgery for decompression on peripheral nerves among 30 patients with diabetes mellitus

Objective To explore the efficacy of microsurgery for decompression on peripheral nerves among patients with diabetic periperal nerve diseases Methods Thirty patients with diabetic peripheral neuropathy underwent surgical decompression on inner malleolus tube nervus tibialis and the branches, knee lateral nervus peronaeus tube common peroneal nerve, musculocutaneous nerve of dorsum pedis in both lower limbs, so as to decompress the nerves, epineurium and bundle membrane. The numbness and pain were observed before and after operation. The sensibility and motor conduction velocity of the above nerves were examed with two point discrimination and sole Neuropad TM test. Results Remission of numbness and pain after surgery reached to 93.33 % and 96.67 %, respectively. The positive rate of sole neuropad TM test was 90.00 %. The sensibility of common peroneal nerve and nervus tibialis together with motor nerve conduction were improved significantly （ P （0.01）, two point discrimination was also improved （ P 〈 0. 01）. Conclusion The mlcrosurgical decompression on cerebromedullary tube stenosis, epineurium and bundle membrane among patients with diabetic peripheral neuropathy can relieve numbness and pain for the patients. The function of the nerves can be improved too.