周围神经损伤的外科处理
Surgical Treatment of Peripheral Nerve Injury

作者: 傅 晨 , 杨成勇 , 陈 群 , 张明建 , 王金光 , 周雪梅 :扬州市第一人民医院骨科东区,扬州;

关键词: 周围神经损伤外科手术Peripheral Nerve Injury Surgical Operation

摘要:
目的:探讨周围神经损伤的外科处理技术及手术疗效。方法:临床各种神经损伤病例共36例,其中采用神经松解术治疗25例,神经吻合术8例,取腓肠神经桥接手术3例。所有病例术后均行神经营养药物及康复治疗。结果:经2~3年随访,其中优21例,良5例,中5例,差5例,观察其中疗效评价为中、差者均为神经移植患者及部分神经吻合患者。结论:周围神经损伤诊断一经成立,原则上手术越早越好。处理臀盖下结构以及胸廓出口周围对医师技术要求较高。主张早期、足量使用神经营养药物并进行早期功能锻炼。

Abstract: Objective: To explore the surgical technique and curative effect of peripheral nerve injury. Methods: Altogether 36 cases with every kinds of peripheral nerve injury were treated by operation. 25 cases were treated by lytic operation, 8 cases were treated by anastomosis, and 3 cases were treated by nerve transplantation with sural nerve. All cases were treated by nerve nutrition drugs and recovery therapy. Results: The follow-up ranged from 2 to 3 years. Excellent results were obtained in 21 cases, good in 5 cases, fair in 5 cases and poor in 5 cases. The cases with poor or fair results were mainly because of nerve transplantation or nerve anastomosis. Conclusions: As soon as the diagnosis of peripheral nerve injury was confirmed, operation should be begun immediately. The technique of control the structure under greatest gluteal muscle and surrending thorax exit is difficult to surgeon. To emphasize using nerve nutrition drugs earlier and full dose, earlier functional exercise also be emphasized. 

文章引用: 傅 晨 , 杨成勇 , 陈 群 , 张明建 , 王金光 , 周雪梅 (2014) 周围神经损伤的外科处理。 亚洲外科手术病例研究, 3, 11-16. doi: 10.12677/ACRS.2014.33003

参考文献

[1] 潘达德, 顾玉东, 侍德等 (2000) 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 9, 133- 134.

[2] 邓红平, 王之宇, 林格生等 (2007) 周围神经损伤的早期显微外科修复. 浙江临床医学, 9, 449-450.

[3] 顾玉东 (2003) 提高周围神经损伤的诊治水平. 中华创伤骨科杂志, 5, 1-2.

[4] 何旭, 张元信, 屈志刚等 (2013) 周围神经损伤与再生的研究进展. 山西医药杂志, 42, 397-398.

[5] 蒋雪生, 周国顺, 管国华等 (2005) 胸廓出口综合征26例术后远期疗效分析. 中华手外科杂志, 21, 328-330.

[6] 陈志强, 周路纲, 王杰峰 (2003) 胸廓出口综合征8例报告. 中国矫形外科杂志, 11, 40.

[7] 崔雅珍, 崔贝贝 (2007) 周围神经再生与神经生长因子给药途径的关系. 中国组织工程研究与临床康复, 8, 2715-2718.

[8] 廖维靖, 曾高 (1995) 周围神经损伤对肌重及肌肉组织脂质过氧化影响的实验研究. 中国康复医学杂志, 10, 209-210.

[9] 蒋斌, 杨佩君 (2000) 四肢常见周围神经损伤的康复问题. 现代康复, 4, 1763-1764.

[10] 杨佩君 (1997) 上肢周围神经损伤的康复治疗. 中华手外科杂志, 13, 210-212.

[11] 裴国献, 王澍寰, 钟世镇 (1999) 显微手外科学. 山东科学技术出版社, 济南, 563.

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