CAJ | 학술논문

目的探讨显微外科治疗颅脑外伤后肢体痉挛状态的疗效.方法回顾分析2006年7月至2008年7月实施的21例显微外科治疗颅脑外伤后肢体痉挛状态,根据不同病例采用相应的选择性周围神经部分切断术,包括:胫神经、肌皮神经、正中神经、尺神经和腰骶段脊神经后根,共计50个肢体.结果术后随访2～24个月,全部患者术后立即感相应肢体痉挛状态缓解,随访期间缓解率为98%(49/50).随访期间运动功能改善率为86%(18/21),生活质量提高率为95%(20/21).术后发生肢体麻木、疼痛等感觉异常26个(52%),肌力下降18个(36%),随访期间均见好转.术后痉挛状态复发1个(2%).结论选择性周围神经部分切断术是治疗颅脑外伤后肢体痉挛状态安全有效的方法.选择适应证及手术时机和术后坚持康复训练是保证疗效的关键.
목적 탐토현미외과치료로뇌외상후지체경련상태적료효.방법 회고분석2006년7월지2008년7월실시적21례현미외과치료로뇌외상후지체경련상태,근거불동병례채용상응적선택성주위신경부분절단술,포괄:경신경、기피신경、정중신경、척신경화요저단척신경후근,공계50개지체.결과 술후수방2～24개월,전부환자술후립즉감상응지체경련상태완해,수방기간완해솔위98%(49/50).수방기간운동공능개선솔위86%(18/21),생활질량제고솔위95%(20/21).술후발생지체마목、동통등감각이상26개(52%),기력하강18개(36%),수방기간균견호전.술후경련상태복발1개(2%).결론 선택성주위신경부분절단술시치료로뇌외상후지체경련상태안전유효적방법.선택괄응증급수술시궤화술후견지강복훈련시보증료효적관건.
Objective To study the effectiveness of microneurosurgical treatment for relief of spasticity of limbs in brain injury patients. Methods 21 patients (50 limbs) of spasticity duo to brain injury were treated by microsurgical selective peripheral neurotomy from July 2006 to July 2008. The peripheral nerves included: tibial, musculocutaneous, median, ulner, and lumbosacral posterior spinal nerves. Results At follow up evaluation( mean duration: 12. 6 months), this study showed that 100% cases experienced disappearance or notable regression of the spasticity right after operation, and the relief percentage in follow - up duration was 98%. The improved motor capacities was found in 86% cases in follow - up duration. Better quality of life was found in 95% cases by follow - up studying. Postoperative complications included dysaesthesias and pain of limbs in 26 limbs (52%), muscle weakness in 18 (36%). All the complications were relieved during follow- up period. There was 1 limb (2%) of recurrence of spasticity. Conclusions Selective peripheral neurotomy is an effective and safe microsurgical method for the treatment of spasticity of limbs in brain injury patients. The proper choice of cases and operation time and long time regular postoperative rehabilitation are keys to gain good effects.