改良通道颈7神经移位直接与患侧下干吻合修复全臂丛神经根性撕脱伤  

Contralateral C7 Root Transfer with a New Pathway for Injured Brachial Plexus Avulsion

作　　者：闫厚军[1] 胡长青[1] 贾迎丽[1] 

机构地区：[1]解放军第252医院手外科,河北保定071000

出　　处：《临床军医杂志》2006年第5期568-569,共2页Clinical Journal of Medical Officers

摘　　要：目的探讨健侧颈7神经经椎体前路与患侧下干直接吻合的可行性及临床效果。方法尸体解剖10例,临床应用2例。将健侧颈7神经近端游离至神经根孔,远端游离至前后股处,于前斜角肌后椎体前建立通道,将健侧颈7神经引导至患侧颈血管鞘和甲状腺间隙处,然后患侧行下干、内侧束、尺神经、及正中神经内侧头广泛游离,患侧屈肘屈肩关节后,将健侧颈7神经直接与患侧下干无张力下吻合。结果共12例,均成功将健侧颈7与患侧下干直接在无张力状态下吻合,未发生副损伤及并发症。结论健侧颈7经椎体前路与患侧下干直接吻合,既减少了桥接神经所致的吻合口,又缩短了神经再生的距离,从而可大大提高神经的恢复效果。Objective To find a new method for better recovery of injured hand muscles in the contralateral C7 root transfer by the pre-cone pathway. Methods Firstly we dissociated the contralateral C7 root from the intervertebral foramen to its divisions. Secondly we set up a tunnel between the cone and the anterior scalenus, Thirdly we moved the C7 root to the gap between the thyroid and the opposite carotid theca through the mentioned tunnel, and then we dissociated the injured brachial plexus extensively. Lastly, we anastomosed the contralateral C7 and the injured inferior trunk. Results The two cases were both treated with contralateral C7 root transfer successfully and without complications or slde-effects. Conclusion This new approach can both decrease the amount of stoma and shorten the distance of nerve regeneration, so it can improve the quality of nerve recovery.

关 键 词：臂丛神经根性撕脱伤 健侧颈7神经 神经修复术 

分 类 号：R622.3[医药卫生—整形外科]