CAJ | 학술논문

背景:伤后手术时间、手术方法选择对周围神经损伤后修复与功能恢复程度具有一定参考价值.目的:探讨相关因素对腓总神经损伤后修复与功能重建的影响.设计:病例分析.单位:中国医科大学第四附属医院骨外科.对象:选择1991-01/2001-01在中国医科大学第四附属医院骨外科病房住院治疗的单纯腓总神经损伤患者18例.男15例,女3例;年龄12～61岁,平均26.5岁;完全断裂9例,不完全断裂3例,卡压1例,挫伤4例,不可逆损伤1例;伤后0.5 h～6个月入院.方法:患者入院后均行腓总神经探查术.行神经吻合12例,神经松解2例,肌腱移位1例,3例保守治疗.术后常规应用抗生素,活血药物及神经营养药物,并指导患者被动功能锻炼,防止关节僵硬及肌肉萎缩.主要观察指标:术后6个月时对腓总神经功能恢复进行评定(优:同侧胫前肌肌力4以上;良:同侧胫前肌肌力3级;可:同侧胫前肌肌力2级;差:同侧胫前肌肌力1级或0级).结果:18例患者均进入结果分析.其中优10例,良6例,可2例,优良率为89%(16/18).结论:对腓总神经损伤患者,确诊后应尽早行一期修复断裂神经,有利于肢体的功能恢复.
배경:상후수술시간、수술방법선택대주위신경손상후수복여공능회복정도구유일정삼고개치.목적:탐토상관인소대비총신경손상후수복여공능중건적영향.설계:병례분석.단위:중국의과대학제사부속의원골외과.대상:선택1991-01/2001-01재중국의과대학제사부속의원골외과병방주원치료적단순비총신경손상환자18례.남15례,녀3례;년령12～61세,평균26.5세;완전단렬9례,불완전단렬3례,잡압1례,좌상4례,불가역손상1례;상후0.5 h～6개월입원.방법:환자입원후균행비총신경탐사술.행신경문합12례,신경송해2례,기건이위1례,3례보수치료.술후상규응용항생소,활혈약물급신경영양약물,병지도환자피동공능단련,방지관절강경급기육위축.주요관찰지표:술후6개월시대비총신경공능회복진행평정(우:동측경전기기력4이상;량:동측경전기기력3급;가:동측경전기기력2급;차:동측경전기기력1급혹0급).결과:18례환자균진입결과분석.기중우10례,량6례,가2례,우량솔위89%(16/18).결론:대비총신경손상환자,학진후응진조행일기수복단렬신경,유리우지체적공능회복.
BACKGROUND: The repair and functional reconstruction of peripheral traumatic nerves depend, on posttraumatic operation time and operative techniques which have certain referential value.OBJECTIVE: To explore the effects of related factors on the repair and functional reconstruction of common peroneal nerve (CPN) after injuries.DESIGN: A case analysis.SETTING: Department of Orthopaedics, Fourth Hospital Affiliated to China Medical University.PARTICIPANTS: Eighteen patients diagnosed with simple CPN injury received treatment in the Department of Orthopedic Surgery of the Fourth Affiliated Hospital, Chinese Medical University, between January 1991 and January 2001. There were 15 males and 3 females aged 12-61 years old with the mean age of 26.5 years; there were 9 cases of complete transection, 3 cases of incomplete transection, 1 case of compression, 4 cases of contusion, and 1 case of irreversible injury. Posttraumatic treatment at hospital was obtained 0.5 hour to 6 months after injury.METHODS: All patients were subjected to CPN explorative operation;neuroanastomosis was performed on 12 cases, neurolysis on 2 cases, tendon graft on 1 case and conservative treatment on 3 cases. Antibiotics were administered after operation together with blood activating medicine and neurotrophic medicine. Moreover, the patients were required to do passive functional exercise in order to avoid arkylosis and myoatrophy.MAIN OUTCOME MEASURES: Functional recovery of CPN was assessed at postoperative 6 months based on the myodynamia of the same side anterior tibia muscles (excellent: above grade 4; good: grade 3; passable: grade 2; poor: grade 1 or grade 0).RESULTS: All the 18 patients entered the results analysis; their outcomes were assessed as excellent in 10 cases, good in 6 cases, and passable in 2cases, with the excellent rate being 89% (16/18).CONCLUSION: Patients diagnosed with CPN injury should be treated with primary repair of traumatic nerves as early as possible, which will benefit the functional recovery of limbs.