尺神经前置术中可吸收膜对电生理的早期疗效  

Early electrophysiological changes after using PDLLA film in the subcutaneous anterior transposition of ulnar nerve

作　　者：徐秀玥[1] 劳杰[1] 

机构地区：[1]上海市复旦大学附属华山医院,上海200040

出　　处：《生物骨科材料与临床研究》2010年第2期13-17,共5页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的观察尺神经前置术中聚乳酸可吸收医用膜对神经电生理恢复的早期效果。方法收集肘管综合征患者共34人:10人为肘部外伤后引起尺神经卡压,24人无明显诱因;均予肘部尺神经松解、皮下前置术。术中尺神经表面包裹可吸收医用膜者19侧,未使用者17侧。随访时间2～15个月。随访肌电图:肘上5cm～肘下5cm神经传导速度、以及在肘部刺激尺神经后于小鱼际肌引出CMAP波幅的术前术后的区别。结果2组在肘部尺神经卡压段的传导速度(MNCV)均有明显改善,其中,对照组1人,观察组3人术前小指展肌无法引出CMAP,MNCV为0,术后有不同程度的恢复。余下患者中,对照组MNCV差值平均改善程度有43.0%,观察组平均改善程度有58.7%,但总体上2组统计学意义上无明显差别。波幅方面,对照组在小指展肌引出的CMAP波幅较术前平均改善程度54.6%,观察组108.3%。且总体上两组波幅改变程度有统计学意义上差别。结论聚乳酸可吸收医用膜在肘部尺神经松解、前置术中对神经电生理早期恢复有一定效果。Obective To observe the early electrophysiological changes after using PDLLA film in the subcutaneous anterior transposition in ulnar nerve. Method We collected 34 patient with cubital tunnel syndrome. 10 of them had syndromes which reflected the compression of ulnar nerve after trauma of their elbows, 24 patients had syndromes with no obvious cause. All of the patients tmderwent the decompression of ulnar nerve at elbow and subcutaneous anterior transposition of the nerve. In the operation, nerves of 19 cases were wrapped by a PDLLA film. The follow-up time ranged from 2 months to 15 months. The follow-up content was to collect elcetromyogram of the patients. We compared the nerve conduction velocities from 5cm above elbow to 5cm below elbow and the wave amplitudes of CMAP which were educed in abductor digiti minimi after stimulating the ulnar nerve at elbow before and after the operation. Results The nerve conduction velocities from 5cm above elbow to 5cm below elbow had improvement in both groups. There was 1 in the control group and 3 in the observed group that CMAP can＇t be educed in the abductor digiti minimi, and the nerve conduction velocities were 0 before operation. These patients had certain improvements after operations. The rest patients showed that： in the control group, MNCV improved about 43% averagely; in the observed group, MNCV improved about 58.7%. However, there was no statistically differences between them totally. The amplitudes of CMAP which were educed in abductor digiti minimi improved about 54.6% averagely in the control group, while it improved about 108.3% in the observed group. Totally, there was statistical differences between two groups in this aspect. Conclusion PDLLA film had some electrophysiological effect in the early period of subcutaneous anterior transposition in ulnar nerve.

关 键 词：神经松解 尺神经前置 聚乳酸可吸收医用膜 

分 类 号：R651.3[医药卫生—外科学]