背阔肌肌皮瓣移位重建晚期臂丛神经上干损伤屈肘功能的疗效评价  

Evaluation on the efficacy of transposition of latissimus dorsi myocutaneous flap on elbow flexion in patients with advanced upper trunk of brachial plexus injury

作　　者：邓海防 DENG Hai-fang(Department of Hand and Foot Microsurgery, East Chinese Medicine Hospital of Heze, Heze Shandong 274000, China)

机构地区：[1]菏泽市中医医院手足显微外科,山东菏泽274000

出　　处：《临床和实验医学杂志》2018年第5期526-529,共4页Journal of Clinical and Experimental Medicine

基　　金：山东省教育厅科研课题(编号:3035b2078)

摘　　要：目的评价背阔肌肌皮瓣移位重建晚期臂丛神经上干损伤屈肘功能的临床疗效。方法采用前瞻性研究法选择菏泽市中医医院2010年1月至2016年10月收治的40例晚期臂丛神经上干损伤屈肘功能患者作为研究对象,所有患者均采用背阔肌肌皮瓣单极移位法重建,根据背阔肌远端固定方式不同分为两组,其中20例背阔肌远端仅固定于肱二头肌视为常规组,另外20例背阔肌远端固定于肱桡肌及肱二头肌视为观察组。比较两组患者手术前后的屈肘肌力以及末次随访的屈肘肌力、力量、角度恢复情况。结果两组患者均获得随访,随访时间为1~3年,平均(1.6±0.5)年。两组患者的背阔肌肌皮瓣均存活,伤后愈合良好,术后至末次随访未见感染等并发症。两组患者手术前后屈肘肌力差异均有统计学意义(P<0.05),但术后的屈肘肌力组间比较差异无统计学意义(P>0.05)。两组患者末次随访时的屈肘肌力、力量、角度差异无均统计学意义(P>0.05)。结论背阔肌肌皮瓣移位重建晚期臂丛神经上干损伤屈肘功能的临床疗效满意。Objective To evaluate the clinical efficacy of transposition of dorsal latissimus muscle flap for reconstructing terminal brachial plexus nerve.Methods A prospective study was conducted on40patients with elbow injury on brachial plexus of upper trunk treated in this hospital during January2010to October2016,all these patients were treated with single pole shift method by using latissimus dorsi myocutaneous flap for reconstruction,according to the latissimus dorsi distal fixation in different ways,they were divided into two groups,including20cases with latissimus dorsi fixed in biceps tendon as routine group,and other20cases with latissimus dorsi distal fixation in humerus radial muscle and biceps tendon as observation group,and the flexion and elbow strength and the angle of recovery were compared between patients of these2groups before and after the operation.Results Patients in these two groups were followed up for1~3years,with an average of(1.6±0.5)years.The latissimus dorsi myocutaneous flap survived in all patients of these two groups,and healed well after injury.No complication such as infection had been found during the last follow-up period.There was significant difference in flexor elbow strength between these two groups before and after operation(P<0.05).There was no significant difference between these two groups(P>0.05),as shown in table1.There was no significant difference in strength and angle of elbow flexion between these two groups in the last follow-up period(P>0.05).Conclusion The clinical curative effect of transposition of dorsal latissimus muscle flap in reconstructing terminal brachial plexus is satisfactory,and its long-term effect is reliable.

关 键 词：臂丛神经上干损伤 背阔肌肌皮瓣 皮瓣移植术 屈肘功能 移位重建 

分 类 号：R688[医药卫生—骨科学]