股薄肌功能性肌肉移植术后肌肉恢复的B超评价  

A preliminary study on B-mode ultrasonic evaluation of muscle recovery after functional gracilis muscle transplantation

作　　者：侯毅 杨建涛[2] 秦本刚[2] 顾立强[2] Hou Yi;Yang Jiantao;Qin Ben-gang;Gu Liqiang(Department of Orthopedics,Henan Provincial People' s Hospital,Zhengzhou 450000,China;Department of Hand Microsurgery and Orthopedic Trauma,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]河南省人民医院骨科,郑州大学人民医院,郑州450000 [2]中山大学附属第一医院显微创伤手外科,广州510080

出　　处：《中华显微外科杂志》2019年第2期105-109,共5页Chinese Journal of Microsurgery

基　　金：国家自然科学基金项目(81871787);河南省医学科技攻关计划省部共建项目(201701017).

摘　　要：目的探讨B超在移植肌术后恢复定量评价中的应用。方法2009年1月至2014年1月,共收治因臂丛损伤接受股薄肌功能性肌肉移植35例,B超测定股薄肌横截面积(CSA),计算肌肉收缩率(CR)、肌肉体积变化率(MBR),并与肌力、关节活动度进行相关性分析,P<0.05为差异有统计学意义。结果术后随访8~24个月,平均22.4个月。移植后肌肉CR平均为(1.23±0.15),与肌力、关节活动度显著相关(P<0.01,r值分别为0.872和0.847),移植后肌力≥M4者的CR大于移植后肌力<M4者[CR分别为(1.35±0.10)和(1.09±0.06)],差异有统计学意义(P<0.05);术后MBR>1共17例,MBR<1共18例,MBR与肌力、关节活动度不存在显著相关性(P>0.05);MBR>1与MBR<1的患者在移植后肌力、关节活动度方面差异无统计学意义(P值分别为0.054和0.284)。结论B超测定肌肉CR可定量反映移植肌肉恢复;移植股薄肌CR增大提示肌肉收缩功能恢复较好。MBR可能不适合用作移植肌肉术后功能的评价。Objective To investigate the value of the B-mode ultrasound method for muscle recovery after transplantation.Methods From January,2009 to January,2014,35 patients of functioning free gracilis muscle transplantation for brachial plexus injury were involved.Using B-mode ultrasound to determine the cross-sectional area(CSA)of transplanted gracilismuscle at rest and contraction state.The contraction ratio(CR)and the muscle bulk ratio(MBR)was calculated based on the CSA.Then the CR and MBR were analysised statistically with manual muscle strength and joint range of motion(ROM)to investigate the correlation.Results The followed-up time was 8-24 months,averaged of 22.4 months.The CR of the transplated muscle was(1.23±0.15),which was significantly correlated with muscle strength and joint ROM(P<0.01,r=0.872,r=0.847,respectively).CR of transplanted muscle with or larger than M4 was greater than that of less than M4[CR were(1.35±0.10),(1.09±0.06),respectively],and the difference was statistically significant(P<0.05).The MBR was greater than 1 in 17 cases,and less than 1 in 18 cases.There was no significant correlation between MBR and muscle strength and ROM(P>0.05).There was no statistically significant difference in muscle strength and ROM between patients with MBR greater than 1 and those with MBR less than 1(P=0.054,P=0.284,respectively).Conclusion The transplanted muscle recovery can be quantitatively reflected by the CR.CR enlargement of the transplanted gracilis muscle indicated a better recovery of muscle contraction function.MBR is not suitable for evaluating function recovery of transplanted muscles.

关 键 词：股薄肌 功能性肌肉移植 B超 肌肉收缩 肌力 

分 类 号：R658.2[医药卫生—外科学]