健侧C_7神经联合多组神经移位治疗全臂丛神经根性撕脱伤正中神经功能随访  

Long-term follow-up for median nerve function after contralateral C_7 nerve and multiple donor nerves transfer for treatment of brachial plexus root avulsion

作　　者：曹鹏克[1] 王伟[1] 李俊明[1] 艾合买提江.玉素甫[2] 

机构地区：[1]漯河医学高等专科学校第二附属医院骨科,河南漯河462300 [2]新疆医科大学第一附属医院

出　　处：《中国骨与关节损伤杂志》2015年第5期449-451,共3页Chinese Journal of Bone and Joint Injury

基　　金：国家自然科学基金(81360270)

摘　　要：目的 探讨健侧C7神经联合多组神经移位治疗全臂丛神经根性撕脱伤后正中神经功能的恢复情况。方法 自2005-06—2010-06诊治40例全臂丛神经根性撕脱伤,首先行臂丛神经探查和健侧C7移位术一期。间隔4~8个月后完成健侧C7移位术二期及附加其他神经移位,按附加手术的不同分为3组,其中第1组10例健侧C7神经根移位于正中神经附加膈神经移位肌皮神经;第2组15例健侧C7神经根移位于正中神经附加肋间神经移位肌皮神经;第3组15例健侧C7神经根分2股分别移位于正中神经和肌皮神经附加副神经移位肩胛上神经。结果 40例获得随访3年余,1、2、3组有效率分别达50%、60%、73.3%。3组间差异无统计学意义（P〉0.05）。结论 健侧C7神经根联合多组神经移位治疗全臂丛神经根性撕脱伤可获得较好的疗效,但不同附加术式未见明显疗效差异。Objective To evaluate median nerve function recovery after contralateral C7 nerve and mukiple donor nerves transfer for treatment of brachial plexus root avulsion. Methods From June 2005 to June 2010, 40 patients with total brachial plexus root avulsion were treated. Brachial plexus exploration and contralateral C7 transposition phase I were performed. After 4-8 months, contralateral C7 transposition phase II and other nerve transfer were performed. According to the different additional surgeries were divided into three groups. Group 1（10 cases）, transferred to the median nerve, additional phrenic nerve transferred to musculocutaneous nerve. Group 2 （15 patients）, transferred to the median nerve and additional intercostal nerve transferred to musculocutaneous nerve. Group 3 （15 patients）, transferred to the median nerve and musculocutaneous nerve, additional accessory nerve transferred to suprascapular nerve. Results Forty patients were followed up for more than 3 years, the effective rate was 50%, 60%, and 73.3% for group 1, 2 and 3 respectively. Among the three groups the difference was not statistically significant（P 〉0.05）. Conclusion Contralateral C7 nerve and multiple donor nerve transfer for treatment of brachial plexus root avulsion get good results, but the difference is not significant in efficaccy among different additional surgiries.

关 键 词：健侧C7移位 臂丛神经损伤 正中神经 

分 类 号：R651.3[医药卫生—外科学]