桡浅神经桡侧支移位重建臂丛神经中下干损伤后手尺侧感觉功能的临床研究  

Clinical study on the reconstruction of hand ulnar sensory function after injury of the middle and lower trunk of the brachial plexus by transfer of the radial branch of the superficial radial nerve

作　　者：许彬 童劲松 张成钢 董震 Xu Bin;Tong Jinsong;Zhang Chenggang;Dong Zhen(Department of Hand Surgery,Huashan Hospital,Fudan University,NHC Key Laboratory of Hand Reconstruction,Shanghai Key Laboratory of Peripheral Nerve and Microsurgery,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院手外科,卫生部手功能重建重点实验室,上海市周围神经显微外科重点实验室,上海200040

出　　处：《中华手外科杂志》2025年第1期52-55,共4页Chinese Journal of Hand Surgery

基　　金：国家自然科学基金项目(81802850);上海市科委项目(18YF1402900);上海市临床重点专科(shslczdzk05601);上海市周围神经显微外科重点实验室(20DZ2270200)。

摘　　要：目的:探讨桡浅神经桡侧支移位术重建臂丛神经中、下干损伤手尺侧感觉功能的临床疗效。方法:我科自2014年至2022年应用桡浅神经桡侧支移位尺神经浅支治疗12例患者(9例臂丛神经颈7-胸1损伤、3例颈8-胸1损伤)。受伤至手术时间为13~28个月,平均19.2个月。术前患者小指及环指尺侧半感觉功能丧失,感觉评分S 0。结果:术后12例患者均获得随访,时间29~131个月,平均82.4个月。所有患者均恢复小指及手尺侧保护性感觉,9例感觉评分S 3,3例S 3+。感觉评分S 3+的3例患者测得两点分辨觉分别为7、8、8 mm。结论:桡浅神经桡侧支移位术是安全、有效的,该术式能够恢复臂丛中、下干损伤后手尺侧感觉功能。Objective:To investigate the clinical efficacy of transfer of radial branch of the superficial radial nerve in reconstructing the sensory function of the ulnar side of the hand in the middle and lower trunk of the brachial plexus injury.Methods:From 2014 to 2022,12 patients(9 cases of brachial plexus nerve injury in the C 7 to T 1 and 3 cases of injury in the C 8 to T 1)were treated in our department by transferring the radial branch of the superficial radial nerve to the superficial branch of the ulnar nerve.The time from injury to surgery was 13 to 28 months,with an average of 19.2 months.Preoperatively,sensory function in the ulnar half of the patient′s little and ring finger was loss,with a sensory score of S 0.Results:All 12 patients were follow-up after surgery for a period of 29 to 131 months,with an average of 82.4 months.All patients recovered protective sensation in the little finger and ulnar side of the hand,with 9 cases scoring S 3 and 3 cases scoring S 3+.The two-point discrimination of three patients with a sensory score of S 3+was 7,8,and 8 mm,respectively.Conclusion:The transfer of radial branch of the superficial radial nerve is safe and effective,and this procedure can restore hand ulnar sensory function after injury to the brachial plexus and lower trunk.

关 键 词：臂丛 神经移位 桡浅神经 尺神经 

分 类 号：R651.3[医药卫生—外科学]