尺神经神经束膜瘤二例  

Two cases report of intraneural perineurioma of the ulnar nerve

作　　者：彭峰[1] 王涛[1] 陈琳[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》2009年第5期258-260,共3页Chinese Journal of Hand Surgery

基　　金：卫生部临床学科重点项目基金资助（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（08DZ2270600）

摘　　要：目的总结2例尺神经神经束膜瘤患者的诊治过程，并对该病进行相关的文献复习。方法例1为女性患者，发现右上臂肿块3年，术前患肢感觉正常，手部运动功能略减退。术中见肘上尺神经呈梭形增粗膨大约4cm×2cm，将肿瘤切除1周后行腓肠神经移植修复。例2为男性患者，发现右肘部肿块3个月，术前右小指刺痛觉减退，手内在肌肌力下降。术中见尺神经于肘部呈梭形增粗膨大约9cm×4cm，切取部分尺神经组织送病理检查。结果术后2例病理报告均为尺神经神经束膜瘤。例1术后随访3个月，未见肿瘤复发，尺神经支配区手功能无恢复。例2术后随访9个月，肿瘤无增大，手功能与术前相同。结论神经内神经束膜瘤是一种少见的良性病变过程，对于病理诊断明确的患者，可手术切除并行神经修复，也可取神经活组织检查，定期随访肿瘤的进展情况。Objective To summarize the diagnosis and treatment of 2 eases of inraneural perineurioma involving the ulnar nerve and review the relevant hterature. Methods Case one was a female patient who had a mass of her fight upper ann for 3 years. Preoperatively the sensation was normal, however the hand movement was impaired. Intraoperatively a 4 cm × 2 cm fusiform enlargement of the ulnar nerve above elbow was seen. The mass was resected and sural nerve graft was done one week later to repair the nerve. Case two was a male patient who had a mass around his right elbow for 3 months. Preoperatively there was diminished sensation of the right little finger and decreased strength of the hand intrinsic muscles. Intraoperatively a 9 cm × 4 cm fusiform enlargement of the ulnar nerve at the elbow was seen. A nerve biopsy was carried out for pathology. Results Pathology for both cases was intraneural perineurioma of the ulnar nerve. Case one was followed for 3 months with no sign of tumor recurrence. Hand functions innervated by the ulnar nerve were unchanged. Case two was followed for 9 months and the mass didn＇t become bigger. Hand function was the same comparing to the preoperative level. Conelusion Intraneural perineurioma is a rare benign tumor. Surgical resection and nerve repair is the treatment option for those with pathologically confirmed cases. Nerve biopsy and regular follow up is another option.

关 键 词：尺神经 病理学 治疗 神经束膜瘤 

分 类 号：R686[医药卫生—骨科学]