健侧C7神经根联合多组神经移位治疗全臂丛神经根性撕脱伤46例  

Multiple donor nerves transfer for the treatment of brachial plexus total roots avulsion of 46 cases

作　　者：徐杰[1] 吴世强[1] 林院[1] 罗奋棋[1] 

机构地区：[1]福建省立医院福建医科大学省立临床医学院,350001

出　　处：《福建医药杂志》2008年第4期1-4,共4页Fujian Medical Journal

基　　金：福建省科技厅青年科技人才创新项目(2004J071);福建省科技厅科技计划重点项目(2000Z122)

摘　　要：目的探讨健侧C7联合多组神经移位治疗臂丛神经根性撕脱伤的方法和疗效。方法对46例全臂丛根性撕脱伤患者采用健侧C7神经根、膈神经、副神经、肋间神经移位治疗,并进行长期随访,观察肩外展、屈肘、屈指和手部感觉功能恢复的情况。结果46例平均随访(4.60±1.25)年。肩外展>30°占59.1%(26/44)。屈肘恢复的总有效率为73.9%(34/46);屈腕指动作恢复有效率为45.7%(21/46),其中肌力≥M3者13例,优良率为28.3%(13/46)。手部感觉恢复有效率为54.3%(25/46)。肋间神经修复胸背神经,38例有不同程度肌力恢复,占82.6%(38/46),其中肌力≥M3者29例,有效率为63.0%(29/46)。结论健侧C7联合多组神经移位治疗全臂丛根性撕脱伤可获得较好疗效。Objective To report the methods and long-term outcomes of contralateral C7 nerve and multiple donor nerves transfer for the treatment of brachial plexus total roots avulsion. Methods Forty-six patients with brachial plexus total roots avulsion were treated by phrenic, accessory, intercostals nerve and contralateral C7 nerve neurotization. The long-term out- comes of shoulder abduction, elbow flexion, wrist and finger flexion and recovery of latissmus dorsi were analysed. Results The follow-up period was averaged （4.60±1.25） year. Shoulder abduction more than 30 degree was achieved in 59.1% （26/ 44） of the patients. The excellent and good elbow flexion was achieved in 73.9% （34/46） of the patients. Wrist and finger flexion recovered in45.7% （21/46） patients, and good rate was 28. 3% （13/46）. Hand protective sensory recovered in 54. 3% （25/46） of the patients. Latissmus dorsi recovered in 82.6% （38/46） of the patients, and good rate was 63.0% （29/ 46）. Conclusion Contralateral C7 nerve and Multiple donor nerves neurotization is a good method for the treatment of brachial plexus total roots avulsion.

关 键 词：臂丛神经 损伤 神经移位 

分 类 号：R651.3[医药卫生—外科学] R622.3[医药卫生—临床医学]