腕部切割伤正中神经断裂Ⅰ期拇对掌功能重建的临床研究  

Clinical study on reconstruction of thumb opposition function in stage Ⅰ of median nerve rupture after wrist cutting injury

作　　者：陈志刚[1] 梁程亮 林景波[1] 何土东 CHEN Zhigang;LIANG Chengliang;LIN Jingbo;HE Tudong(Huangpu People's Hospital of Zhongshan,Zhongshan 528429,China)

机构地区：[1]中山市黄圃人民医院,广东中山528429

出　　处：《临床医学研究与实践》2024年第35期34-37,共4页Clinical Research and Practice

基　　金：2021年度中山市第一批社会公益与基础研究项目(医疗卫生一般项目)(No.2021B1131)。

摘　　要：目的探讨腕部切割伤正中神经断裂Ⅰ期拇对掌功能重建的临床效果,为该类患者的治疗提供参考。方法选取2021年2月至2023年5月收治的30例腕部切割伤导致的正中神经断裂拇对掌功能损伤患者为研究对象,随机将其分为观察组和对照组,每组15例。观察组采取Ⅰ期正中神经吻合及Ⅰ期拇对掌功能重建,对照组采取Ⅰ期正中神经吻合及Ⅱ期拇对掌功能重建。比较两组的治疗效果。结果观察组的手指关节总活动度(TAM)达标率以及Carroll手功能评分合格率均显著高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的36项简化版健康调查问卷(SF-36)评分高于对照组,差异具有统计学意义(P<0.05)。观察组的并发症总发生率为6.67%,低于对照组的40.00%,差异具有统计学意义(P<0.05)。结论Ⅰ期正中神经吻合及Ⅰ期拇对掌功能重建治疗方案能够有效恢复腕部切割伤导致正中神经断裂拇对掌功能损伤患者的手功能,提高手部感觉敏感度,明显改善生活质量,并减少术后并发症,值得临床推广。Objective To investigate the clinical effect of reconstruction of thumb opposition function in stageⅠof median nerve rupture after wrist cutting injury,and to provide a reference for the treatment of such patients.Methods A total of 30 patients with thumb opposition function injury caused by median nerve rupture after wrist cutting injury admitted from February 2021 to May 2023 were selected as the research objects and randomly divided into observation group and control group,with 15 cases in each group.The observation group was treated with median nerve anastomosis in stageⅠand reconstruction of thumb opposition function in stageⅠ,while the control group was treated with median nerve anastomosis in stageⅠand reconstruction of thumb opposition function in stageⅡ.The therapeutic effects of the two groups were compared.Results The total active motion(TAM)compliance rate and the quality rate of Carroll hand function score in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the Medical Outcomes 36-Item Shot-Form Health Survey(SF-36)score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was 6.67%,which was lower than 40.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion The median nerve anastomosis in stageⅠand reconstruction of thumb opposition function in stageⅠcan effectively restore the hand function of patients with thumb opposition function injury caused by median nerve rupture after wrist cutting injury,elevate hand sensory sensitivity,significantly improve the quality of life,and reduce postoperative complications,which is worthy of clinical promotion.

关 键 词：腕部切割伤 神经断裂 拇对掌功能 

分 类 号：R651.3[医药卫生—外科学]