肘部尺神经内囊肿三例报告  

Clinical reports of intraneural cyst of ulnar nerve at the elbow

作　　者：彭峰[1] 杨剑云[1] 虞聪[1] 吴鹏[1] 张莉[1] 黄绍敏[1] 陈琳[1] 

机构地区：[1]复旦大学附属华山医院手外科 卫生部手功能重建重点实验室上海市周围神经显微外科重点实验室,上海200040

出　　处：《中华手外科杂志》2013年第4期195-197,共3页Chinese Journal of Hand Surgery

基　　金：卫生部国家l临床重点专科建设项目（2010）;上海市周围神经显微外科重点实验室基金项目（08DZ2270600）

摘　　要：目的总结3例肘部尺神经内囊肿的诊治过程，并对该病进行相关的文献综述，为临床提供治疗经验。方法2011年3月至2012年10月，对3例临床和神经电生理诊断为肘部尺神经损伤的患者进行手术治疗。术中探查发现尺神经主干外膜下有囊性肿块，囊肿位于肘关节下方，均行囊肿切开引流术，对其中2例含有囊肿的尺神经关节支予以结扎、切除。结果术后随访2～16个月，平均8．7个月。术后肘部胀痛消失，尺侧一指半刺痛觉好转。按照肘管综合征功能评定标准评定：良2例，可1例。结论肘部尺神经内囊肿十分罕见。对于临床诊断明确的患者，目前多行神经外膜切开引流术。Objective Three cases of ulnar nerve intraneural ganglion cyst at the elbow joint were reported and the relevant literatures were reviewed to summarize the clinical experiences. Methods From March 2Oll to October 2012, 3 patients who were diagnosed with ulnar nerve neuropathy at the elbow by clinical judgment and electrophysiology were surgically treated. All three patients were male. The right side was affected in all three. Numbness of the small finger and ulnar side of the ring finger, decreased muscle power in intrinsic muscles and positive Tinel＇s sign were noted. A mass was palpated around the elbow joint only in one patient, while claw hand was observed in two cases. Surgical exploration of the ulnar nerve revealed a cystic mass in the epineuritan of the ulnar nerve at a level immediately below the elbow joint. The cysts were incised to drain the contents and decompress the nerve. An artic^ar branch leading to the elbow joint was identified in two cases and ligated and resected. Results The patients were follow-up for 2 to 16 months postoperatively, with an average of 8.7 months. Elbow pain and discomfort disappeared. Numbness and tingling of the ulnar one and half fingers alleviated. Functions of the ulnar nerve were improved and there was no sign of intraneural cyst recurrence. Conclusion Ulnar nerve intraneural ganglion cyst around the elbow is not common. For patients with definite clinical diagnosis, the treatment of choice is surgical decompression of the ulnar nerve by cyst incision and drainage along with resection of the affected articular branch when exists.

关 键 词：尺神经 治疗结果 神经内囊肿 

分 类 号：R651.3[医药卫生—外科学]