摘要
目的通过比较早期神经修复术和后期肌腱移位术治疗桡神经麻痹(RNP)患者手部功能重建的远期效果,探讨RNP治疗的干预时机与手术方式的选择。方法回顾性分析2014年1月至2019年12月该院收治的67例接受手术治疗的RNP患者的临床资料,接受神经修复术36例(神经修复组),进行肌腱移位术31例(肌腱移位组)。比较两组患者围术期情况,随访两组患者疗效。两组患者均获随访12~27个月。结果神经修复组患者术后拇长伸肌肌力、手功能恢复情况均明显优于肌腱移位组,腕关节屈伸与掌指关节活动度、患肢握力均明显高于肌腱移位组,差异均有统计学意义(P<0.05);两组患者上肢功能评定表、生活质量评分比较,差异均无统计学意义(P>0.05)。结论神经修复术与肌腱移位术均为RNP的有效治疗方法,神经修复术治疗早期RNP患者更具有优势,而肌腱移位术适用于桡神经损伤1年以上者。
Objective To investigate the intervention timing and selection of operation method for the treatment of radial nerve palsy(RNP)via comparing the long-term clinical effect of early stage nerve repair and later period tendon transference on the hand functional reconstruction of the patients with RNP.Methods The clinical data 67 patients with RNP receiving surgical treatment in this hospital from January 2014 to December 2019 were retrospectively analyzed,including 36 cases of nerve repair(nerve repair group)and 31 cases of tendon transference(tendon transference group).The perioperative situation was compared between the two groups.The effects were followed up in the two groups.The follow up in the two groups lasted for 12-27 months.Results The postoperative muscle strength of extensor hallucis longus and hand function recovery in the nerve repair group were significantly superior to those in the tendon transference group(P<0.05).The wrist flexion and extension,metacarpophalangeal joint motion range and injuried limb grip strength in the nerve transfer group were significantly higher than those in the tendon transference group,and the differences were statistically significant(P<0.05),while there were no statistically significant differences in the DASH and the QOL scores between the two groups(P>0.05).Conclusion The nerve repair and tendon transference were both effective treatment methods of RNP.The nerve repair has more advantages for treating early stage RNP,while the tendon transference is suitable for the patients with radial nerve injury over one year.
作者
陈子豪
黎立
艾尔肯·热合木吐拉
司裕
周泓宇
李靖扬
CHEN Zihao;LI Li;AIERKEN·Rehemutula;SI Yu;ZHOU Hongyu;LI Jingyang(Third Department of Orthopedics,Affiliated Hospital of Traditional Chinese Medicine,Xinjiang Medical University,Urumqi,Xinjiang 830000,China)
出处
《重庆医学》
CAS
2022年第13期2258-2262,共5页
Chongqing medicine
基金
新疆维吾尔自治区卫生健康青年医学科技人才专项基金资助项目(WJWY202034)。
关键词
神经修复
肌腱移位
桡神经麻痹
神经损伤
nerve repair
tendon transference
radial nerve palsy
nerve injury
