正中及尺神经部分束早期移位治疗臂丛C5-7根性损伤的长期疗效观察  

Transfer Early of Partial Fascicles of Median and Ulnar Nerve for Treating the C5-7 Root Injury of Brachial Plexus: Analysis of Long-term Result

作　　者：徐房添[1] 高辉[1] 赖光松[1] 姬广林[1] 刘午阳[1] 徐芳[2] 杨千绮 陈睿云[1] 艾芳[1] 

机构地区：[1]赣南医学院第一附属医院骨科,江西赣州341000 [2]赣南医学院第一附属医院肌电图室,江西赣州341000

出　　处：《赣南医学院学报》2015年第6期910-912,923,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：赣州市科技局科技计划项目(编号:2012057)

摘　　要：目的:分析正中及尺神经部分束早期移位治疗臂丛C5、C6、C7根性损伤中重建屈肘功能的长期疗效。方法:对11例臂丛C5-7根性损伤,确诊后早期施行神经移位术:正中神经部分束移位至肌皮神经的肱二头肌支、尺神经部分束移位至肱肌肌支,双重移位,重建屈肘功能。术中运用电生理技术,增加手术的合理性和准确性。并进行平均67.8个月的长期随访,按结果分析疗效。结果:优9例,良2例,屈肘功能恢复满意。6例于术后3个月肱二头肌、肱肌肌电图即能检出再生电位。一例术后6个月肱二头肌才检出再生电位,该病人于伤后8个月才施行手术。结论:臂丛C5-7根性损伤确诊后,早期正中及尺神经部分束双重移位是重建屈肘功能安全有效的方法,较之单一的尺神经束移位(Oberlin术式)提高了屈肘功能的修复效率,具有效果好、恢复快、操作简单的优点。Objective： To evaluate the long-term results of reconstructing elbow flexion by transferring early of partial fascicles of median and ulnar nerve for treating the C5-7 root injury of brachial plexus. Methods： Eleven patients with the complete C5-7 root injury were surgically treated to reconstruct elbow flexion function with the double nerve transfer. The motor fascicle from the median nerve was transferred to the biceps branch of the musculocutaneous nerve, and the partial branch of the ulnar nerve to the brachialis branch. The electrophysiological technique was carried out before and during operation in order to improve the feasibility and accuracy of procedures. Results： All patients were followed up from 37 months to 96 months （67.8 months on average）. The elbow flexion function was rated as excellent in 9 cases, as good in 2 cases and the recovery results are satisfied. There was the regenerative potential in biceps and brachialis of 6 patients 3 months after operation. One of patients was showed the regenerative potential in biceps 6 months postoperatively while he was operated 8 months after injury. Conclusion： The double nerve transfer early in reconstructing elbow flexion is more effective and reasonable than transfer with the partial ulnar nerve only after diagnosed as the C5-7 root injury, which has improved the efficiency of elbow flexion reconstruction.

关 键 词：臂丛 C5-7根性损伤 屈肘功能重建 神经移位 

分 类 号：R651.3[医药卫生—外科学]