老年尺神经松解前置术后主动活动与制动的临床疗效分析  

THERAPEUTIC EFFECT EVALUATION OF ULNAR NEUROLYSIS AND NERVE ANTERIOR TRANSPOSITION WITH AN IMMEDIATE RANGE OF MOTION IN THE AGED

作　　者：陈燕花[1] 洪光祥[1] 王发斌[1] 陈振兵[1] 康皓[1] 

机构地区：[1]华中科技大学同济医学院协和医院手外科,武汉430022

出　　处：《中国修复重建外科杂志》2006年第8期809-811,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的研究老年患者肘管综合征行尺神经松解前置术后患肢不制动的临床疗效。方法1999年1月～2004年12月,收治43例老年肘管综合征患者,其中男24例,女19例。年龄60～81岁,平均67岁。病程2～10个月。随机分为两组,A组20例,B组23例,均行尺神经松解前置术,A组术后患肘用石膏托外固定3周,B组不用外固定,第2天开始活动观察患肢感觉、力量、两点辨别觉、Tinal征,以及恢复工作生活时间等,采用Bishop评分系统评价两组患者功能恢复情况。结果术后获随访1～5年,两组患者的尺神经功能有较大的改善,组间比较差异无统计学意义(P>0.05);A组恢复日常活动或原有工作时间平均需45.2±5.1d,B组平均需15.5±3.8d,两组比较差异有统计学意义(P<0.05)。经Bishop评分,A组优14例,良4例,中、差各1例;B组优16例,良4例,中2例,差1例,两组间无差异(P>0.05)。结论老年患者尺神经松解前置术后即行功能锻炼能更早恢复日常活动或原有工作。Objective To investigate the clinical therapeutic effect of the ulnar neurolysis and nerve anterior transposition with an immediate range of motion for the cubital tunnel syndrome in the aged. Methods Forty-three patients （24 males and 19 females, aged 60-81 years, averaged 67） admitted for the cubital tunnel syndrome from January 1999 to December 2004 were randomly divided into 2 groups： Group A （n=20） and Group B （n=23）, with an illness course of 2-10 months. All the patients underwent the ulnar neurolysis and the nerve anterior transposition. After operation the patients＇ elbows in group A were immobilized with the plaster slab for an external fixation for 3 weeks; the patients＇ elbows in group B did not use the external fixation, but began an immediate range of motion on the 2nd day after operation. The Bishop scoring system was used to evaluate the patients＇ functional recovery in the 2 groups. Results The follow-up for 1-5 years showed that the ulnar nerve function of all the patients were improved but no significant differences were found between the 2 groups （P〉 0. 05）. The patients in Group A returned to daily activities or work at 45.2± 5. 1 days, but the patients in Group B required 15.5±3.8 days, with a significant difference between the 2 groups （P〈0. 05）. According to Bishop scoring system, the resutls were excellent in 14 cases, good in 4 cases, fair in 1 case and poor in 1 case in Group A, and 16, 4, 2 and 1 respectively in Group B. There was no significant difference between the two groups（P〉0.05）. Conclusion The ulnar neurolysis and nerve anterior transposition with an immediate range of motion for the cubital tunnel syndrome can promote the ulnar function recovery of the old-aged patients. They can return to their daily activities or work at a more rapid speed when their elbows are mobilized immediately after operation.

关 键 词：肘管综合征 尺神经松解前置术 老年人 

分 类 号：R688[医药卫生—骨科学]