中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2011年
6期
457-460
,共4页
顾立强%张德春%向剑平%秦本刚%戚剑%李平%朱庆棠%傅国%劳镇国%刘小林%朱家恺
顧立彊%張德春%嚮劍平%秦本剛%慼劍%李平%硃慶棠%傅國%勞鎮國%劉小林%硃傢愷
고립강%장덕춘%향검평%진본강%척검%리평%주경당%부국%로진국%류소림%주가개
臂丛%根性损伤%临床分型
臂叢%根性損傷%臨床分型
비총%근성손상%림상분형
Brachial plexus%Root injury%Clinical classification
目的 探讨成人臂丛根性损伤的临床分型. 方法 回顾性研究中山大学附属第一医院近5年来收治并手术探查证实、资料完整的成人臂丛根性损伤病例,分析、归纳出成人臂丛根性损伤临床分型. 结果 总结155例臂丛根性损伤病例,结合术前临床诊断与影像学诊断、术中探查与电生理学检测、术后随访研证,初步归纳出成人臂丛根性损伤临床分型,在上臂丛损伤(A型)、下臂丛损伤(B型)、全臂丛损伤(C型)三大类基础上,可进一步细分为七小类:①上臂丛损伤AⅠ型:C5、6根完全性损伤(撕脱或断裂),伴或不伴膈神经损伤；②AⅡ型:C5-7根完全性损伤；③AⅢ型:C5～7根完全性损伤伴C8、T1不全性损伤；④下臂丛损伤BⅠ型:C8、T1(或伴C7)完全性损伤；⑤BⅡ型:T1、C7、8完全性损伤伴C5、6不全损伤；⑥全臂丛损伤CⅠ型C5～T1根性撕脱伤；⑦CⅡ型:T1、C7、8根性撕脱伤伴C5、6根断裂. 结论 成人臂丛根性损伤可分为三大类七小类,但臂丛根性损伤临床分型的分布不平均,以上臂丛损伤(A型)(55.5％)和全臂丛损伤(C型)(40.6％)最为常见,下臂丛损伤(C型)最少(3.9％).上臂丛损伤A型中,AⅢ型最多(61.6％),AⅡ型次之(31.4％),AⅠ型最少(7％).
目的 探討成人臂叢根性損傷的臨床分型. 方法 迴顧性研究中山大學附屬第一醫院近5年來收治併手術探查證實、資料完整的成人臂叢根性損傷病例,分析、歸納齣成人臂叢根性損傷臨床分型. 結果 總結155例臂叢根性損傷病例,結閤術前臨床診斷與影像學診斷、術中探查與電生理學檢測、術後隨訪研證,初步歸納齣成人臂叢根性損傷臨床分型,在上臂叢損傷(A型)、下臂叢損傷(B型)、全臂叢損傷(C型)三大類基礎上,可進一步細分為七小類:①上臂叢損傷AⅠ型:C5、6根完全性損傷(撕脫或斷裂),伴或不伴膈神經損傷；②AⅡ型:C5-7根完全性損傷；③AⅢ型:C5～7根完全性損傷伴C8、T1不全性損傷；④下臂叢損傷BⅠ型:C8、T1(或伴C7)完全性損傷；⑤BⅡ型:T1、C7、8完全性損傷伴C5、6不全損傷；⑥全臂叢損傷CⅠ型C5～T1根性撕脫傷；⑦CⅡ型:T1、C7、8根性撕脫傷伴C5、6根斷裂. 結論 成人臂叢根性損傷可分為三大類七小類,但臂叢根性損傷臨床分型的分佈不平均,以上臂叢損傷(A型)(55.5％)和全臂叢損傷(C型)(40.6％)最為常見,下臂叢損傷(C型)最少(3.9％).上臂叢損傷A型中,AⅢ型最多(61.6％),AⅡ型次之(31.4％),AⅠ型最少(7％).
목적 탐토성인비총근성손상적림상분형. 방법 회고성연구중산대학부속제일의원근5년래수치병수술탐사증실、자료완정적성인비총근성손상병례,분석、귀납출성인비총근성손상림상분형. 결과 총결155례비총근성손상병례,결합술전림상진단여영상학진단、술중탐사여전생이학검측、술후수방연증,초보귀납출성인비총근성손상림상분형,재상비총손상(A형)、하비총손상(B형)、전비총손상(C형)삼대류기출상,가진일보세분위칠소류:①상비총손상AⅠ형:C5、6근완전성손상(시탈혹단렬),반혹불반격신경손상；②AⅡ형:C5-7근완전성손상；③AⅢ형:C5～7근완전성손상반C8、T1불전성손상；④하비총손상BⅠ형:C8、T1(혹반C7)완전성손상；⑤BⅡ형:T1、C7、8완전성손상반C5、6불전손상；⑥전비총손상CⅠ형C5～T1근성시탈상；⑦CⅡ형:T1、C7、8근성시탈상반C5、6근단렬. 결론 성인비총근성손상가분위삼대류칠소류,단비총근성손상림상분형적분포불평균,이상비총손상(A형)(55.5％)화전비총손상(C형)(40.6％)최위상견,하비총손상(C형)최소(3.9％).상비총손상A형중,AⅢ형최다(61.6％),AⅡ형차지(31.4％),AⅠ형최소(7％).
Objective To explore the clinical classification of the brachial plexus root injury in adult. Methods All 155 cases of adult brachial plexus root injury in the First Affiliated Hospital of Sun Yat-sen University,were collected and analyzed on their characteristic,operative methods,and clinical outcome so as to find the distribution and incidence of different type of brachial plexus root injury and set up the clinical classification of adult brachial plexus root injury.Results Brachial plexus root injuries in adult could be classified into three types and seven subtypes.Type A is upper brachial plexus root injury,including type AⅠ (C5,C6 completely avulsion or rupture injury,with/without phrenic nerve injury),type AⅡ (C5-C7 completely injury),and type AⅢ (C5-C7 completely injury accompanied with C8,T1 incompletely injury).Type B is lower brachial plexus root injury,including type BⅠ[ C8,T1 (with/without C7)completely injury ] and type BⅡ (C8,T1,C7 completely injury,accompanied with C5、6 incompletely injury).Type C is total brachial plexus root injury,including type CⅠ(C5-T1 completely root avulsion) and type CⅡ(C7-T1 root avulsion accompanied with C5、6 root or trunk rupture).For the cases of every type,u pper brachial plexus root injury type A have 86 cases,in which type AⅠ 6 cases,type AⅡ 27 cases and type AⅢ 53 cases; lower brachial plexus root injury type B have 6 cases,in which type BⅠ 2 cases and type BⅡ 4 cases; total brachial plexus root injury type C have 63 cases,in which type CⅠ 51 cases and type CⅡ 12 cases. Conclusion Except the upper,lower,and total three types,brachial plexus root injuries in adult could be classified further into seven subtypes.The distribution of different type of adult brachial plexus root injury is overbalance:upper type A (55.5％) is more often seen,total type C(40.6％) followed and lower type B(3.9％) is the least seen.In upper brachial plexus root injury,type AⅢ(61.6％) is more often seen,type AⅡ(31.4％) followed and type AⅠ(7％) is less seen.
