目的:2型糖尿病(DM2)患者可能发生颈动脉狭窄(CAS),需要手术干预.颈动脉内膜切除术(CEA)后的神经损伤是一种罕见且经常无法识别的术后副作用。此病例报告描述了内部CEA后有较大耳廓和三叉神经炎症状的患者的诊断过程和康复过程。
方法:患者是一名患有DM2的81岁女性,接受了左侧内部CEA。随后,她的左颈部和面部出现肿胀,以及沿着大耳廓和三叉神经通路的疼痛。相关的检查结果包括切口放置在耳廓大神经和颈部淋巴管的路径,引流面部,上面的疤痕粘连。手术后12天开始物理治疗,包括动员和手动淋巴引流,模态,和kinsiotape的应用。
结果:患者特定功能量表(PSFS)从评估时的10/30提高到出院时的27/30。肿胀和疼痛明显减轻,患者报告睡眠没有困难,咀嚼,或者出院时说话。报告的疼痛水平与整个治疗过程中面部肿胀的波动一致相关。
结论:DM2患者可能出现心血管疾病的症状,需要侵入性外科手术.DM2会对神经和血管结构造成损害,易感患者神经损伤或超敏反应。此病例报告显示术后面部肿胀与头颈部神经刺激之间可能存在联系。动员和手动淋巴引流,模态,和kinsiotape能有效减轻疼痛和肿胀。
结论:物理治疗师具有独特的资格,评估,并治疗与CEA相关的术后肿胀和神经痛。
2型糖尿病患者可能发生颈动脉狭窄(CAS),需要手术干预.颈动脉内膜切除术(CEA)后的神经损伤是一种罕见且经常无法识别的术后副作用。物理治疗师在内部CEA后诊断并为具有较大耳廓和三叉神经炎症状的患者提供治疗。
OBJECTIVE: Patients with type 2 diabetes mellitus (DM2) may develop carotid artery stenosis (CAS), requiring surgical intervention. Nerve injury following carotid endarterectomy (CEA) is a rare and often unrecognized post-operative side effect. This case report describes the diagnostic process and rehabilitation course of a patient with greater auricular and trigeminal neuritis symptoms following internal CEA.
METHODS: The patient is an 81-year-old woman with DM2 who underwent a left internal CEA. She subsequently developed swelling in her left neck and face, and pain along the greater auricular and trigeminal nerve pathways. Pertinent examination findings included incision placement across the path of the greater auricular nerve and cervical lymphatic vessels that drain the face, with overlying scar adhesion. A course of physical therapy was initiated 12 days after surgery, and included mobilization and manual lymphatic drainage, modalities, and application of kinesiotape.
RESULTS: The Patient Specific Functional Scale (PSFS) improved from 10/30 at evaluation to 27/30 at discharge. Swelling and pain were significantly reduced, with patient reporting no difficulty with sleeping, chewing, or talking at discharge. The reported pain level consistently correlated with fluctuations in face swelling throughout treatment.
CONCLUSIONS: Patients with DM2 may present with symptoms of cardiovascular disease, requiring invasive surgical procedures. DM2 can cause damage to neural and vascular structures, predisposing patients to nerve injuries or hypersensitivity following procedures. This case report demonstrates a likely connection between post-operative facial swelling and nerve irritation in the head and neck. Mobilization and manual lymphatic drainage, modalities, and kinesiotape were effective to reduce pain and swelling.
CONCLUSIONS: Physical therapists are uniquely qualified to identify, evaluate, and treat post-operative swelling and nerve pain associated with CEA.
Patients with type 2 diabetes mellitus may develop carotid artery stenosis (CAS), requiring surgical intervention. Nerve injury following carotid endarterectomy (CEA) is a rare and often unrecognized postoperative side effect. Physical therapists diagnose and provide treatment to patients with greater auricular and trigeminal neuritis symptoms following internal CEA.