摘要
目的 评价严重自体压迫性上臂桡神经损伤的手术疗效.方法 对2005年3月至2009年8月收治的8例自体压迫性桡神经损伤患者进行回顾性总结.8例中有5例是由于醉酒后致腕指下垂畸形,3例由外伤昏迷所致.发病距手术时间为2～6个月,平均3.6个月.手术探查发现上臂桡神经主干及深支上有受压病变,5例出现腊肠样改变,其中3例有2处呈腊肠样改变.3例行神经外膜松解术；5例将病变段神经切除,其中2例直接缝合,3例取腓肠神经移植修复.结果 术后随访9个月至3年,6例伸腕、伸指、伸拇肌力恢复至M3～M4,2例效果较差.根据中华医学会手外科学会上肢功能评定试用标准评定：优4例,良2例,可2例.结论 严重自体压迫性桡神经损伤手术治疗大部分患者可取得良好的疗效.
Objective To assess the surgical outcomes of severe radial nerve injury caused by compression in the upper arm.Methods Eight patients of severe radial nerve injury caused by compression in the upper arm who received surgery in our department from March 2005 to August 2009 were analyzed retrospectively.Wrist drop happened after being drunk in 5 patients and after traumatic coma in 3 patients.The interval from paralysis to surgery was 2 to 6 months（mean 3.6 months）.All patients were treated surgically.The radial nerve was exposed to reveal compression constrictions at the main trunk of the radial nerve and the posterior interosseous nerve.Sausage-like changes were seen in 5 cases.There were two-part sausage-like changes in 3 cases.External neurolysis was carried out in 3 cases,while resection of the constricted portions of the nerves was done in the other 5 patients.Direct nerve coaptation was achieved in 2 cases whereas nerve-grafting had to be done in 3 cases.Results The patients were follow-up from 9 months to 3 years after the operation.Six patients regained at least grade-4 muscle power in the involved muscles.The other two patients who had been treated by nerve-grafting had poor results.According to the upper limb functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association the treatment outcomes were good in 4 cases,fair in 2 cases and poor in 2 cases.Conclusion Surgical treatment is effective for most of the severe compressive radial nerve injury patients.
出处
《中华手外科杂志》
CSCD
北大核心
2012年第1期36-38,共3页
Chinese Journal of Hand Surgery
关键词
桡神经
显微外科手术
压迫
Radial nerve
Microsurgery
Compression
