膈神经移位至肌皮神经两种术式肌电随访结果的比较分析  

Comparison of two procedures of phrenic nerve transfer to musculocutaneous nerve: an analysis of EMG follow-up results

作　　者：徐文东[1] 马建军[1] 沈丽英[1] 徐建光[1] 张成钢[1] 张家胜[1] 顾玉东[1] 

机构地区：[1]上海复旦大学附属华山医院手外科,200040

出　　处：《中华手外科杂志》2001年第1期19-21,共3页Chinese Journal of Hand Surgery

基　　金：上海市领先学科基金资助项目! (95 Ⅲ 1 ) ;上海市科委启明星计划基金资助项目!(97QB1 4 0 1 4 )

摘　　要：目的　对两种术式的膈神经移位至肌皮神经后的肌电随访结果进行统计学分析 ,总结两者的各自规律 ,为临床选择术式和判断疗效提供肌电检测依据。方法　回顾性地对行两种术式病例的长期肌电随访资料进行统计学分析。有有效随访资料者 49例 ,其中膈神经加移植神经移位至肌皮神经主干2 1例 ;膈神经移位至上干前股肌皮神经束 2 8例。总结两者的肌电恢复有效率 ;用Kaplan Meier法估计最早出现有效再生电位的平均时间。结果　膈神经加移植神经移位至肌皮神经主干组的有效率为 90 .5 % ;最早出现有效再生电位的时间为术后 [(3 60 .0 0± 48.97)d , x±s x,下同 ]。膈神经移位至上干前股肌皮神经束组的有效率为 78.6% ;最早出现有效再生电位的时间为术后 (2 2 8.0 0± 5 9.10 )d。结论　膈神经加移植神经移位至肌皮神经主干组的肌电恢复有效率 ,高于膈神经移位至上干前股肌皮神经束组 ,但最早出现有效新生电位的时间要比后者晚 13 0d左右。Objective To evaluate two procedures of phrenic nerve transfer to musculocutaneous nerve by statistical analysis of the electromyography follow - up results, and to provide electrophysiological basis for surgical procedure selection and judgement of treatment outcome. Methods Retrospective analysis of the long - term electrophysiological examination data of two phrenic nerve transfer procedures were carried out in 49 cases. The phrenic nerve was transferred to the musculocutaneous nerve with nerve graft in 21 cases, and to anterior division of the upper trunk in 28 cases. The effective rate of electrophysiological recovery was summarized. The average time of the earliest appearance of efficacious regeneration potential was estimated by Kaplan - Meier method. Results The effective rate of phrenic nerve transfer to the musculocutaneous nerve with nerve graft and to the anterior division of the upper trunk was 90.5 % and 78.6 % respectively. The earliest time of appearance of efficacious regeneration potential was (360.00 ± 48.97) days and (228.00 ± 59.10) days respectively. Conclusions The effective rate of phrenic nerve transfer to musculocutaneous nerve with nerve graft was greater than that of phrenic nerve transfer to the anterior division of the upper truck. But as for the earliest time of appearance of efficacious regeneration potential, the former was approximately 130 days later than the latter.

关 键 词：膈神经 肌电扫描术 随访研究 神经移位 

分 类 号：R651.3[医药卫生—外科学]