摘要
目的用电生理方法检测并评价臂丛神经上干不全损伤的程度，建立晚期不全产瘫手术方式选择的客观标准。方法１９９５年１月～１９９６年６月，对１６例年龄在１岁１个月～１岁８个月的晚期不全产瘫患儿进行神经松解术治疗，术前、术中用“两侧”及“两端”复合动作电位（ＣＭＡＰ）波幅衰减的电生理检测来评价臂丛神经上干不全损伤的程度及神经瘤的传导质量；并随访晚期产瘫松解手术的疗效。结果１６例术前患侧冈上肌、三角肌及肱二头肌的ＣＭＰＡ波幅与健侧相比，衰减了６０％以上。术中松解后刺激神经瘤近、远端，三肌近端波幅比远端波幅平均衰减３７．４５％±２０．９７％、４７．８５％±２６．２３％和４７．０５％±２１．２３％。术后平均随访１９．８个月，肩、肘功能无改善。结论术前两侧对比ＣＭＡＰ波幅衰达在６０％以上的１～２岁不全产瘫患儿应选择神经移位或移植术。
Objective Using electrophysiological method to evaluate the severity of incomplete obstetric paralysis brachial plexus injuries, and establish an electrophysiological criteria for selection of operative procedure in the treatment of cases of late stage. Methods Neurolysis was performed in 16 patients, and during the operation, the neuroma at the upper trunk was discovered. The electrophysiological study was carried out before and during operation to evaluate the conducting function of neuroma. In the follow up the operative result was analysed by Mallet test. Results The preoperative study showed that the compound muscular active potential (CMAP) amplitude of supraspinatus deltoid and biceps were decreased more than 60% in comparison with that of the healthy side. After external neurolysis of the neuroma, by stimulation of the proximal and distal ends of the neuroma the average decrease of CMAP amplitude of the above three muscles was 37.45%± 20.97%, 47.85%±26.23%, 47.05%±21.23%, respectively and no significant improvement was observed in the shoulder and elbow function in all of the 16 cases. Conclusion When the preoperative electrophysiological study found that the CMAP amplitude decreased more than 60% in comparison with that of the healthy side,transposition of nerve or nerve grafting was indicated.
出处
《中国修复重建外科杂志》
CAS
CSCD
1999年第2期75-78,共4页
Chinese Journal of Reparative and Reconstructive Surgery
基金
上海市领先学科基金
关键词
产瘫
周围神经损伤
产伤
电生理
手术方式
Palsy Birth injury Periphereal nerve Conduction quality Electrophysiology Foundation item: Leader Discipline Foundation of Shanghai (95001)
