带尺侧下副动脉尺神经松解前置术治疗肘管综合征  

DECOMPRESSION AND ANTERIOR TRANSPOSITION OF ULNAR NERVE WITH INFERIOR ULNAR COLLATERAL ARTERY FOR CUBITAL TUNNEL SYNDROME

作　　者：赵民[1] 邵新中[2] 田德虎[2] 吴金英[3] 李大村[1] 李建峰[1] 刘井达[1] 赵亮[1] 王利民[1] 姜桂芳[1] 

机构地区：[1]中国医科大学北京顺义医院上肢外科,北京101300 [2]河北医科大学第三医院手外科 [3]首都医科大学燕京医学院解剖教研室

出　　处：《中国修复重建外科杂志》2008年第9期1044-1046,共3页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：首都医学发展科研基金资助项目(2005-3114)~~

摘　　要：目的总结带尺侧下副动脉尺神经松解前置术治疗肘管综合征的手术方法及临床效果。方法2005年9月-2006年5月,采用保留尺侧下副动脉在尺神经上的吻合支,行带血供尺神经松解前置术治疗25例肘管综合征。男19例,女6例;年龄20～72岁,平均60岁。发病至手术时间2个月～3年,平均6.7个月。发病原因:骨性关节炎23例,肘管内囊肿及尺神经滑脱各1例。术前按Pasque肘管综合征评分系统评定:可19例,差6例。电生理检查:肘关节周围尺神经运动神经传导速度<42m/s。结果术后切口均Ⅰ期愈合,无手术并发症及复发患者。25例术后均获随访,随访时间1年～2年半,平均13.9个月。按Pasque肘管综合征评分系统评定:优15例,良9例,可1例,优良率96%;与术前评定结果比较,差异有统计学意义(P<0.05)。电生理检查;肘关节周围尺神经运动神经传导速度>42m/s。结论带尺侧下副动脉尺神经松解前置术是治疗肘管综合征的安全有效方法之一。Objective To report the operation method and the clinical effect of decompression and anterior transposition of the ulnar nerve with inferior ulnar collateral artery for cubital tunnel syndrome. Methods From September 2005 to May 2006, 25 cases of cubital tunnel syndrome were treated by the method of decompression and anterior transposition of the ulnar nerve with inferior ulnar collateral artery. There were 19 males and 6 females with an average of 60 years （20-72 years）. The disease course was 2 months to 3 years （mean 6.7 months）. The causes were ostesarthritis in 23 cases, cubital tunnel cyst in 1 case and ulnar nerve olisthy in 1 case. According to Pasque grading system for cubital tunnel syndrome, 19 cases were graded as good and 6 cases were graded as poor. Electrophysiological examination showed the motor nerve conduction velocity of the ulnar nerve around the elbow joint was less than 42 m/s. Results All wounds healed by first intention and no operative complications and recurrences occurred. All patients were followed up for one year to two and half years （13.9 months on average）. According to Pasque grading system for cubital tunnel syndrome, 15 cases were graded as excellent, 9 cases as good and 1 case as fair. The excellent and good rate was 96%, indicating a significant difference compared with the results before operation （P 〈 0.05）. Electrophysiological examination showed the motor nerve conduction velocity of the ulnar nerve around the elbow joint was more than 42 m/s. Conclusion The method of decompression and anterior transposition of the ulnar nerve with inferior ulnar collateral artery is safe and effective for the treatment of cubital tunnel syndrome.

关 键 词：肘管综合征 神经卡压 尺侧下副动脉 尺神经前置术 

分 类 号：R687.2[医药卫生—骨科学]