CAJ | 학술논문

目的：评估膈神经功能测定在臂丛神经损伤神经移植前的应用价值，术后电生理观察神经移植恢复状况。方法：对50例臂丛神经损伤患者术前进行了膈神经功能测定，对其中10例膈神经功能正常者，行同侧膈神经移植肌皮神经手术，术后神经电生理随访观察肱二头肌肌电图及肌皮神经运动传导功能状况。结果：臂丛神经损伤患者约28％伴膈神经损伤，损伤的膈神经不能选择为移植动力神经。隔神经移植肌皮神经后，最早3个月出现再生电位，6个月后出现运动单位电位，12个月后运动单位电位明显增多。术后肱二头肌肌力18个月后恢复优良占80％。7例术后12个月肌皮神经引出运动神经传导电位。结论：膈神经功能测定在臂丛神经损伤患者术前可评估选择移植神经，术后电生理可随访观察神经功能恢复状况，对臂丛神经损伤患者的手术治疗有一定指导作用。
목적：평고격신경공능측정재비총신경손상신경이식전적응용개치，술후전생리관찰신경이식회복상황。방법：대50례비총신경손상환자술전진행료격신경공능측정，대기중10례격신경공능정상자，행동측격신경이식기피신경수술，술후신경전생리수방관찰굉이두기기전도급기피신경운동전도공능상황。결과：비총신경손상환자약28％반격신경손상，손상적격신경불능선택위이식동력신경。격신경이식기피신경후，최조3개월출현재생전위，6개월후출현운동단위전위，12개월후운동단위전위명현증다。술후굉이두기기력18개월후회복우량점80％。7례술후12개월기피신경인출운동신경전도전위。결론：격신경공능측정재비총신경손상환자술전가평고선택이식신경，술후전생리가수방관찰신경공능회복상황，대비총신경손상환자적수술치료유일정지도작용。
Objective:To evaluate applied phrenic nerve function determination before nerve trans‐plantation for brachial plexus and the recovery status after transplantation through electrophysiological observation .Methods:Determinations of phrenic nerve function were performed in 50 patients with brachi‐al plexus injury .The ipsilateral phrenic nerves of 10 patients with normal phrenic nerve function were transplanted as musculocutaneous nerves .Postoperative follow‐up electrophysiological observations were made on the transplanted nerves using biceps electromyograms and the motion conduction function of the musculocutaneous nerves .Results:About 28% of the patients with brachial plexus injuries also suffered from phrenic nerve injuries .The injured phrenic nerves could not be transplanted as motor nerves .The re‐productive potential appeared at least 3 months after the transplantation of phrenic nerves as musculocu‐taneous nerves .The motor unit potential appeared 6 months later and significantly increased 12 months‐later .The patients with good recovery of myodynamia of biceps muscles after transplantation accounted for 80% .Motor nerve conduction potential was detected on the postoperative musculocutaneous nerves in 7 patients 12 months after the transplantation .Conclusion:Preoperative determination of phrenic nerve functions of patients with brachial plexus injury can be used to evaluate and choose the nerves to be trans‐planted .Postoperative follow‐up electrophysiological observations contvibutes to neural functional recov‐ery and to the operative the treatment of patients with brachial plexus injury .