中华手外科杂志
中華手外科雜誌
중화수외과잡지
CHINESE JOURNAL OF HAND SURGERY
2014年
6期
439-441
,共3页
臂丛%神经移位%治疗结果%上干损伤
臂叢%神經移位%治療結果%上榦損傷
비총%신경이위%치료결과%상간손상
Brachial plexus%Nerve transfer%Treatment outcome%Upper trunk injury
目的 探讨多组神经移位术治疗复杂性臂丛神经上干损伤的临床疗效.方法 2009年3月至2012年6月,对7例臂丛神经上干损伤,且均合并膈神经及臂丛神经中、下干不全损伤的患者,采用副神经、肋间神经及桡神经肱三头肌长头肌支移位术,重建肩外展及屈肘功能.结果 术后7例患者获得17～ 26个月的随访.术后4～6个月受区肌肉均可以记录到新生电位.末次随访时,肩外展恢复至60°～130°,冈上、下肌肌力M46例,M31例;三角肌肌力M4 5例,M32例;屈肘恢复至90°～ 130,肱二头肌肌力M45例,M32例.动力神经供区未出现运动功能受损表现.结论 副神经、肋间神经及桡神经肱三头肌长头肌支组合的多组神经移位术,在治疗复杂性臂丛神经上干损伤时可取得较好的临床疗效.
目的 探討多組神經移位術治療複雜性臂叢神經上榦損傷的臨床療效.方法 2009年3月至2012年6月,對7例臂叢神經上榦損傷,且均閤併膈神經及臂叢神經中、下榦不全損傷的患者,採用副神經、肋間神經及橈神經肱三頭肌長頭肌支移位術,重建肩外展及屈肘功能.結果 術後7例患者穫得17～ 26箇月的隨訪.術後4～6箇月受區肌肉均可以記錄到新生電位.末次隨訪時,肩外展恢複至60°～130°,岡上、下肌肌力M46例,M31例;三角肌肌力M4 5例,M32例;屈肘恢複至90°～ 130,肱二頭肌肌力M45例,M32例.動力神經供區未齣現運動功能受損錶現.結論 副神經、肋間神經及橈神經肱三頭肌長頭肌支組閤的多組神經移位術,在治療複雜性臂叢神經上榦損傷時可取得較好的臨床療效.
목적 탐토다조신경이위술치료복잡성비총신경상간손상적림상료효.방법 2009년3월지2012년6월,대7례비총신경상간손상,차균합병격신경급비총신경중、하간불전손상적환자,채용부신경、륵간신경급뇨신경굉삼두기장두기지이위술,중건견외전급굴주공능.결과 술후7례환자획득17～ 26개월적수방.술후4～6개월수구기육균가이기록도신생전위.말차수방시,견외전회복지60°～130°,강상、하기기력M46례,M31례;삼각기기력M4 5례,M32례;굴주회복지90°～ 130,굉이두기기력M45례,M32례.동력신경공구미출현운동공능수손표현.결론 부신경、륵간신경급뇨신경굉삼두기장두기지조합적다조신경이위술,재치료복잡성비총신경상간손상시가취득교호적림상료효.
Objective To investigate the results of multiple nerve transfers for treatment of complex brachial plexus upper trunk injuries.Methods Between March 2009 and June 2012,7 patients who sustained brachial plexus upper trunk injuries with concomitant phrenic nerve and middle and lower trunk partial injuries were treated with accessory nerve transfer,intercostal nerve transfer and triceps long head branch transfer to restore shoulder abduction and elbow flexion.Results All the patients were follow-up for 17 to 26 months postoperatively.Nascent potentials were recorded in the recipient muscles in all the patients 4 to 6 months after the surgery.At last follow-up evaluation shoulder abduction returned to 60° to 130°,with supraspinatus and infraspinatus muscle power of M4 in 6 cases,M3 in 1 case and deltoid muscle power of M4 in 5 cases and M3 in 2 cases.Elbow flexion returned to 90° to 130°,with biceps muscle power of M4 in 5 cases and M3 in 2 cases.There was no impairment of motor functions related to the donor nerves.Conclusion Multiple nerve transfers,involving accessory nerve,intercostal nerves and the triceps long head branch,may achieve a better treatment outcome in complex brachial plexus upper trunk injuries.
