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深圳大学总医院 神经外科

糖尿病周围神经病变:Dellon教授访谈

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https://www.neurovascular.com.cn   

Lee Dellon Live on CNN  (中文部分是我的注释)

https://www.dellon.com/深圳大学总医院神经外科徐祎

WHITFIELD: For most of us, a pinched nerve can be pretty annoying. For a diabetic, a pinched nerve in the foot can eventually lead to amputation or even death.(糖尿病足可能导致截肢甚至死亡)

Dr. Lee Dellon is a plastic surgeon who developed a surgical technique to decompress nerves and prevent such problems. I talked to him about the procedure.(Dellon教授发明了神经减压手术,解决糖尿病足问题)

DR. A. LEE DELLON, DIR., DELLON INSTITUTES: When a nerve is compressed for long period of time, the sensory nerve fibers stop working, you lose feeling in your foot, many people have pain. When you lose feeling in your foot, you're at risk or ulceration, infection and one out of six people with diabetes who develops neuropathy will have an ulcer and then go on, one out of six of those, to have an amputation.(下肢神经受到卡压,感觉纤维就会停止工作,患者足部感觉消失,还会出现足部疼痛。如果你的脚出现麻木,你就有足部溃疡、感染的风险,出现足部神经痛的糖尿病患者中有六分之一会出现溃疡,出现溃疡的患者中又有六分之一需要截肢)

WHITFIELD: And so your innovative approach will perhaps keep a lot of folks hopefully from having to think about amputation or even have it carried out. This nerve decompression works how?

DELLON: Well, I'm very excited about this. I think most viewers will know what carpal tunnel syndrome is, when a nerve that's this big is pinched in your wrist. And people know that if you operate and open the covering of the pinched nerve, the nerve wakes up, numbness goes away.

And we've taken that same approach to the feet. We identify in people with diabetics and symptoms who have numbness and tingling, areas where the nerve is compressed in their ankle, their knee and the top of their foot. When we open up these tight places, life comes back into the nerves and no one we've operated on since 1982 has had an ulcer or an amputation.(1982年开展下肢神经减压术后,没有一例患者出现足部溃疡以及截肢)。

WHITFIELD: So you feel pretty confident about the results. What are the potential side effects?(副作用有哪些?)

DELLON: Well, not everybody gets a great result, but 80 percent of the people do. Eighty percent of the people, when we tap, if they feel tingling in their fingers, will have a chance to get a good result.(不是每个人都有效,有效率在80%。有足部刺痛症状的患者,有效率在80%)。

Because we operate on the foot and the stitches are near the ankle, we do allow people to walk right away. The surgery is an outpatient procedure and when people can walk right away, the stitches may pull through the skin.

So a potential complication is that the wound may not heal. About one out of 100 patients who will have this problem and wound will heal slowly over five to eight weeks.(潜在的并发症是手术伤口愈合不佳,发生率在1%,这些病人的伤口需要5到8周才会愈合完全)

WHITFIELD: And so, again, how can a patient kind of detect themselves whether there is a nerve problem whether it's by way of the wrist or even ankle as you were demonstrating?

DELLON: Well, it's a very exciting thing. If take the same idea about the hand and you apply it to the foot, we know that the nerve in the ankle crosses right here and if a patient at home crosses their leg, if they're a diabetic and they wonder if they have a problem, if they just will tap along their ankle.

And if they feel something go into their toes or into the arch of their foot or even their heel, they'll know there's life left in that nerve. We can release it and patient will have an 80 percent chance of relief of pain and recover of sensibility in their foot.

WHITFIELD: All right. Now you give a very rosy outlook on this treatment, but not everyone is on board with it, namely the American Diabetes Association. They're using words like unproven therapies. How do you dispute that?(美国糖尿病学会认为该项手术还未得到完全证实,你的意见?)


DELLON: Well, I'm a plastic surgeon and the research that I have published and that the other doctors I've trained have published, appears in the surgery journals. The medical doctors are just coming to read what we've written.(我们的研究报告、文章主要在外科杂志上发表,内科医生刚刚接触到这些文章)

The medical doctors actually agree that if there is a compressed nerve in the foot, the ankle or the knee, the nerve should be decompressed. The American Diabetes Association quite rightly is very conservative and I agree with them, that not every diabetic should have this operation.(内科医生同样赞同如果足部的神经受到卡压,那么就应该做减压手术。美国糖尿病学会比较保守,我也赞同他们的意见:即不是所有的糖尿病患者都适合这种手术)

But if you're a diabetic with a nerve compression, I believe the medical doctors would agree with my statement that that nerve should be decompressed.(对于确有神经卡压的糖尿病患者,相信内科医生会同意并赞成行神经减压手术)

WHITFIELD: Dr. A. Lee Dellon, thanks so much for your time.

 

 

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