非脑瘫病因性痉挛状态的显微神经外科手术治疗  

Microneurosurgical Treatment for Relief of Spasticity of Noncerebral Palsy Patients

作　　者：于炎冰[1] 张黎[1] 徐晓利[1] 马延山[2] 

机构地区：[1]卫生部中日友好医院神经外科,北京100029 [2]北京市丰台医院神经外科,北京100071

出　　处：《中国临床神经外科杂志》2006年第5期260-262,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨显微神经外科手术治疗多种(主要为非脑瘫)病因所致痉挛状态的疗效。方法2000年3月至2005年6月我院采用显微神经外科手术治疗多种(主要为非脑瘫)病因所致痉挛状态356例。根据病例的不同情况采用相应的选择性周围神经部分切断术．包括胫神经、坐骨神经、肌皮神经、正中神经、尺神经、闭孔神经、副神经、颈段和腰骶段脊神经前、后根。结果全部患者平均随访28个月。95．2%患者术后即感痉挛状态缓解,随访期间缓解率为90．7%,运动功能改善率为87．6%,生活质量提高率为91．3%。术后肢体感觉障碍发生率23．3%,肌无力发生率19．5%,随访期间均见不同程度好转。术后痉挛状态不同程度复发33例(9．3%)。结论选择性周围神经部分切断术是治疗多种(主要为非脑瘫)病因所致痉挛状态安全有效的手术方法。Objective To explore the curative effect of microneurosurgery on relief of spasticity in the patients with noncerebral palsy. Methods The microsurgieal selective peripheral neurotomy was performed for the relief of spacticity from March 2000 to June 2005 in 356 patients without cerebral palsy. The peripheral nerves on which the selective neurotomy was performed included tibial, sciatic, musculocutaneous, median, ulner, obturator and accessory nerves, and the anterior and posterior roots of cervical and lumbosacral spinal nerves. Results All the patients were averagely followed up for 28 months. The spasticity was relieved immediately after the operation in 95.2% of all the patients. During the following-up period, the rate of relieving spasticity was 90.7%, the rate of the ira-proving motor function were 87.6%, and 91.3% of all the patients had better quality of llfe compared to the preoperation. The postoperative complication included dysesthesia in 128 limbs （23.3%） and muscle weakness in 107 limbs （19.5%）. The spasticity recurred after the operation in 33 patients （9.3%）. Conclusion Selective peripheral neurotomy is an effective and safe method for the treatment of spastieity in the patients without cerebral palsy.

关 键 词：痉挛状态 非脑瘫 显微手术治疗 周围神经 

分 类 号：R616.2[医药卫生—外科学] R651.3[医药卫生—临床医学]