经胸膈神经移位治疗臂丛神经损伤  

Transthoracic phrenic nerve transfer for treatment of the brachial plexus injury

作　　者：张高孟[1] 张丽银[1] 赵新[1] 王涛[1] 顾玉东[1] 

机构地区：[1]复旦大学华山医院手外科,上海200040

出　　处：《中华手外科杂志》2002年第1期7-9,共3页Chinese Journal of Hand Surgery

基　　金：上海市卫生局领先学科基金资助项目 (95 Ⅲ 1 )

摘　　要：目的　观察经胸膈神经移位到上臂中下段正中神经后组神经束的手术效果。方法　选择10例经术前的体征、肌电检查 ,并经术中肌电及探查 ,明确诊断为早期全臂丛根性撕脱伤的患者。在对其行经胸膈神经移位到上臂中下段正中神经后组神经束 (含前骨间神经、掌长肌支、指深屈肌近侧支 )的同时也行其它神经移位 ;包括健侧C7后股、健侧胸前神经等移位术 ,以恢复病人肩、肘、腕、手的功能。结果　 10例患者术后随访 6～ 2 8个月 ,其中最早手术的 3例于术后 2年已比较满意地恢复了有关功能 ,其余7例由于术后时间较短尚在恢复之中。结论　经胸膈神经移位术能恢复手的部分功能 。Objective To observe the treatment outcome of transthoracic phrenic nerve transfer to posterior part of the median nerve trunk at the middle and distal part of the arm.Methods 10 patients with total brachial plexus roots avulsion at the early stage were involved in the study, which were diagnosed clearly by preoperative physical examination, electromyography and intraoperative electromyography and operative exploration. Phrenic nerve transfer to posterior part of the median nerve trunk at the middle and distal part of the arm (containing anterior interosseous nerve, muscle branch to palmaris longus, proximal branches to flexor digitorum profundus). The other nerve transfers included C 7 posterior division and anterior thoracic nerve from healthy side, for restoration of functions of shoulder, elbow, wrist and hand. Results 10 cases were followed up for 6 ～ 28 months. Function restoration was obtained satisfactorily 2 years after operation in the earliest 3 patients, while the other 7 patients were in recovering process due to short followed up period.Conclusion Transthoracic phrenic nerve transfer makes partial recovery of hand function and repair of the distal tip of phrenic nerve possible.

关 键 词：神经移位 臂丛神经损伤 经胸膈神经移植位术 手功能 

分 类 号：R651.3[医药卫生—外科学]