CAJ | 학술논문

目的采用神经远断端逆向追踪定位、近断端电刺激定位相结合的方法,对正中神经返支精确对位修复,最大限度地恢复大鱼际肌的功能.方法对3例腕部正中神经断裂伤的患者,自正中神经返支发出处逆行追踪至腕部断伤处,准确定位.局部麻醉下对近端正中神经在神经刺激仪定位下分别刺激,刺激时如手指无感觉而大鱼际肌有酸胀、疼痛等不适感觉的那一束,定为正中神经返支.用10-0线精确对位缝合.结果术后随访时间为6个月至1年,大鱼际肌外形饱满,肌力达5级,拇指对掌、对指功能恢复良好.结论对于腕部正中神经切割伤,正中神经返支的精确修复,能较好地恢复大鱼际肌的功能.
목적 채용신경원단단역향추종정위、근단단전자격정위상결합적방법,대정중신경반지정학대위수복,최대한도지회복대어제기적공능.방법 대3례완부정중신경단렬상적환자,자정중신경반지발출처역행추종지완부단상처,준학정위.국부마취하대근단정중신경재신경자격의정위하분별자격,자격시여수지무감각이대어제기유산창、동통등불괄감각적나일속,정위정중신경반지.용10-0선정학대위봉합.결과 술후수방시간위6개월지1년,대어제기외형포만,기력체5급,무지대장、대지공능회복량호.결론 대우완부정중신경절할상,정중신경반지적정학수복,능교호지회복대어제기적공능.
Objective Electric stimulation of the proximal end and retrograde dissection of the distal end of the median nerve transected at wrist level were used to localize the thenar branch for accurate repeir in order to achieve maximum recovery of opposing function of the thumb. Methods Three patients with clear cut injury of the median nerve at the wrist were treated. Recurrent branch fascicle at the distal cut end was localized by retrograde dissection of the recurrent branch. The recurrent branch fascicle at the proximal cut end was decided as the fascicle that elicited thenar discomfort or pain under electric stimulation. The recurrent branch fascicles were accurately approximated and the median nerve was repaired with 10-0 suture. Results The patients were followed for 6 months to 1 year. Excellent shape of thenar eminence was obtained in all three patients and recovery of opposing function was satisfactory. Muscle power was M<,5->. Conclusion Accurate alignment of recurrent branch in repair of median nerve injury at the wrist leads to satisfactory recovery of thenar muscle function.