骨间前神经转移修复鱼际肌支伤恢复手内肌功能的实验研究及临床应用  

TRANSPLANTATION OF ANTERIOR INTEROSSEOUS NERVE TO REPAIR THENAR BRANCH EXPERIMENTAL STUDY AND CLINICAL APPLICATION

作　　者：朱盛修[1] 王岩[1] 黄钢[1] 

机构地区：[1]解放军总医院

出　　处：《解放军医学杂志》1994年第1期39-41,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：为满意地恢复去神经手内肌功能，作者设计了骨间前神经转移修复鱼际肌支或尺神经深支伤，进行了有关神经显微解剖和动物实验研究。结果表明，本手术方法符合解剖生理及中枢神经系统代偿调节协同肌功能，由于各神经束解剖结构相接近，转位修复后，其远端再生神经纤维数量及成熟度接近正常。有髓纤维通过率达１５６．１６％。临床经治２０例病人，其中１５例随诊１～６年（平均３年），肌力均有不同程度恢复，１０例肌电图为正常肌电位，计Ｍ＿２２例，Ｍ＿３４例，Ｍ＿４６例，Ｍ＿５３例。讨论了手术适应证。Recovery of intrinsic muscle motor function after nerve injuris at the wrist is unpredictable despite a good sensory recovery. For the median nerve , there is only 6%motor fibres and 94%sensory fibres at the wrist level, and mismatching during recovery is highly probable. Since 1979, the branch of anterior interosseous nerve to the pronator quadratus was anastomose to the motor branches of the median nerve or ulnar nerve to restore the function of the intrinsic hand mus- cles. 20 patients , with different injuries at the wrist or distal forearm , were treated by this new technique. 15 patients were followed up for 1- 6 years postoperatively. In 3 patients, muscle strength has been regained to normal, 6 to grade Ⅳ, 4 to grade Ⅲand 2 to gradeⅡ. The rele- vant applied anatomy of the motor branch of the median nerve, deep branch of ulnar nerve and an- terior interosseous nerve were studied.12 Rhesus monkeys were also used for the experimental study. In conclusion, with this technique complete intrinsic muscle function of the band after median or ulnar nerve in wrist or distal forearm might be erstored.

关 键 词：周围神经 骨间前神经 手 鱼际肌支 

分 类 号：R658.2[医药卫生—外科学]