膈神经移位接上干前股的疗效分析  

Outcomes analysis of phrenic nerve transfer to anterior division of the upper trunk of brachial plexus

作　　者：董震[1] 成效敏[1] 顾玉东[1] 

机构地区：[1]复旦大学附属华山医院手外科,上海200040

出　　处：《中华手外科杂志》2007年第2期85-86,共2页Chinese Journal of Hand Surgery

摘　　要：目的通过对40例采用膈神经移位接上干前股以恢复屈肘功能的臂丛损伤患者的长期随访,分析与疗效相关的不良因素,为进一步提高其疗效及选择最佳手术适应证提供基础。方法对2002年—2005年在我院进行膈神经移位接上干前股治疗的40例患者进行长期随访,观察其疗效及与疗效相关的因素。结果40例患者屈肘功能恢复的总有效率为82.5%,其中年龄大于40岁、病程超过1年、术前膈神经诱发电位潜伏期(LAT)衰减≥20%者,疗效较差。结论膈神经移位接上干前股手术简单、创伤小、疗效满意,适宜在临床上推广应用于臂丛神经股部无损伤的患者。但对年龄大于40岁、病程超过1年、术前膈神经LAT衰减≥20%者,应慎用。Objective To analyze the risk factor related to the effectiveness by taking a long period follow-up study of 40 brachial plexus injuried patients whose phrenic nerve transferred to the anterior division of upper trunk to recover the function of elbow flexion, and to help to improve the effectiveness and select the best surgical indication. Methods A long period follow-up study was carried out in 40 patients who had been operated with phrenic nerve transfer to the anterior division of upper trunk from 2002 to 2005, the effectiveness and the factors related were observed. Results The effectiveness of the elbow flexion function recovery of 40 patients was 82.5 %. But the effectiveness of the patients whose age over 40, course of disease over one year and the attenuation of pre-operative latency of phrenic nerve evoked potential （LAT） ≥ 20% was not good. Conclusion The surgical procedure of phrenic nerve transfer to the anterior division of upper mink has such advantages as satisfied outcome, simple manipulation and minor trauma, and it can be advocated for clinical application to treat the patients whose division of brachial plexus is fine. But to those whose age over 40, course of disease over one year and the attenuation of pre-operative LAT of phrenic nerve ≥ 20% , it should be used carefully.

关 键 词：膈神经 臂丛 神经移位 随访研究 

分 类 号：R651.3[医药卫生—外科学]