阿霉素神经干注射联合神经瘤切除或松解治疗痛性神经瘤  

Treatment of painful neuroma by intraneurai injection of adriblastine combined with neuroma resection or neurolysis

作　　者：王涛[1] 罗鹏波[1] 虞庆[1] 刘靖波[1] 张高孟[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》2008年第6期329-331,共3页Chinese Journal of Hand Surgery

基　　金：卫生部临床学科重点基金资助项目（2007-66）;上海市周围神经显微外科重点实验室课题基金资助项目（05DE22108）

摘　　要：目的介绍一种治疗痛性神经瘤的新方法和初步临床疗效。方法2002年～2006年，应用阿霉素神经干注射联合神经瘤切除或松解治疗痛性神经瘤患者9例。其中8例切除残端神经瘤后，将神经近端置于正常的软组织内；1例连续性神经瘤仅做神经松解。所有病例均在神经瘤切除或松解后，根据神经干粗细的不同分别用1％的阿霉素0．3～1．0ml作近端神经干注射。结果经过24—60个月的临床随访，7例残端神经瘤患者的疼痛明显缓解，1例疼痛减轻，1例无效（仅做神经松解），手术优良率为77．8％。结论阿霉素神经干注射联合神经瘤切除能有效缓解残端神经痛。Objective To introduce a novel method to treat painful neuroma and evaluate the preliminary chnical outcomes. Methods From 2002 to 2006, 9 patients with painful neuromas were treated. The surgical technique included neuroma resection and embedding of the proximal nerve end into adjacent normal soft tissue in 8 patients and neurelysis in 1 patient. According to the size of the nerve, 0.3 to 1.0 ml of 1% adriblastine was injected into the proximal nerve stump. Results The mean follow-up was 34 months （range, 24 to 60 months）. Seven of the 9 patients experienced complete and permanent pain relief. Some mild degree of pain returned in 1 patient. Postoperative pain level was not changed for the patient who underwent neurelysis and intraneural adriblastine injection. The overall effective rate was 77. 8%. Conclusion Stump pain caused by painful neuroma can be effectively treated by neuroma resection and intraneural adriblastine injection .

关 键 词：周围神经 神经瘤 疼痛 外科手术 阿霉素 

分 类 号：R686[医药卫生—骨科学]