中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2010年
1期
33-35
,共3页
张卫国%曲巍%吕德成%傅重洋
張衛國%麯巍%呂德成%傅重洋
장위국%곡외%려덕성%부중양
尺神经%治疗效果%FK506
呎神經%治療效果%FK506
척신경%치료효과%FK506
Ulnar nerve%treatment outcome%FKS06
目的 探讨使用复合他克莫司(FK506)壳聚糖鞘管小间隙套接治疗尺神经离断伤的临床效果.方法 2003年2月至2006年4月,选取前臂尺神经锐器切割离断伤患者35例,采用复合FK506壳聚糖鞘管套接神经远近端,保留神经断端5.0mm间距,并注意防止神经断面间的扭曲对位,间隙内注入生理盐水,鞘管远近端与神经各缝合3针固定.术后石膏制动4周.结果 31例患者经10个月至2年的随访,按中华医学会手外科学会上肢部分功能评定试用标准进行疗效评定,其中优26例(84%)、良4例(13%)、可1例(3%).结论 采用保留神经断端小间隙法复合FK506壳聚糖鞘管套接治疗尺神经损伤既可有效预防断端间的瘢痕组织侵入,又能较好地发挥神经趋化作用,有效促进神经的再生.
目的 探討使用複閤他剋莫司(FK506)殼聚糖鞘管小間隙套接治療呎神經離斷傷的臨床效果.方法 2003年2月至2006年4月,選取前臂呎神經銳器切割離斷傷患者35例,採用複閤FK506殼聚糖鞘管套接神經遠近耑,保留神經斷耑5.0mm間距,併註意防止神經斷麵間的扭麯對位,間隙內註入生理鹽水,鞘管遠近耑與神經各縫閤3針固定.術後石膏製動4週.結果 31例患者經10箇月至2年的隨訪,按中華醫學會手外科學會上肢部分功能評定試用標準進行療效評定,其中優26例(84%)、良4例(13%)、可1例(3%).結論 採用保留神經斷耑小間隙法複閤FK506殼聚糖鞘管套接治療呎神經損傷既可有效預防斷耑間的瘢痕組織侵入,又能較好地髮揮神經趨化作用,有效促進神經的再生.
목적 탐토사용복합타극막사(FK506)각취당초관소간극투접치료척신경리단상적림상효과.방법 2003년2월지2006년4월,선취전비척신경예기절할리단상환자35례,채용복합FK506각취당초관투접신경원근단,보류신경단단5.0mm간거,병주의방지신경단면간적뉴곡대위,간극내주입생리염수,초관원근단여신경각봉합3침고정.술후석고제동4주.결과 31례환자경10개월지2년적수방,안중화의학회수외과학회상지부분공능평정시용표준진행료효평정,기중우26례(84%)、량4례(13%)、가1례(3%).결론 채용보류신경단단소간극법복합FK506각취당초관투접치료척신경손상기가유효예방단단간적반흔조직침입,우능교호지발휘신경추화작용,유효촉진신경적재생.
Objective To report the clinical outcomes of repairing ulnar nerve rupture using FK506 chitosan chamber combined with small gap coaptation technique. Methods Thirty-five patients with ulnar nerve sharp cut injuries were treated with FK506 chitosan chamber combined with small gap coaptation technique from February 2003 to April 2006. The severed nerve ends were tucked in the tube leaving a 5.0 mm gap in between. Caution was used to avoid twisting and wrong alignment of the two nerve ends. The gap was filled with normal saline. The nerve was secured to the tube with 3 stitches at both ends. A plaster was applied for 4 weeks postoperatively to immobilize the limb. Results Thirty-one patients were followed up for 10 months to 2 years. The functional recovery was evaluated according to the criteria for upper limb functional assessment issued by the Chinese Medical Association Hand Surgery Society. The results were rated as excellent in 26 cases (84%), good in 4 cases (13%) and fair in 1 case (3%). Conclusion FK506 Chitosan chamber combined with small gap coaptation technique can effectively prevent the growth of scar tissue into the nerve gap and facilitate chemotactic axonal growth. It is beneficial for nerve regeneration.