神经肌腱缝合治疗神经瘤性残端痛的实验研究与临床应用  

The experimental study and clinical application of anastomosis of nerve to tendon for treatment of neuromatic stump pain

作　　者：张君[1] 魏壮[1] 刘飙[1] 尹维田[1] 高庆国[1] 

机构地区：[1]吉林大学中日联谊医院手外科,长春130031

出　　处：《中华手外科杂志》2003年第2期82-83,共2页Chinese Journal of Hand Surgery

摘　　要：目的　探讨治疗神经瘤性残端痛的一种新方法。方法　取SD大鼠 3 0只 ,按手术先后随机分成 2组 ,每组 15只。实验组 :切断一侧的坐骨神经 ,将其近端与同时切断的同侧跟腱近端缝合。对照组 :将一侧坐骨神经切除 1.0cm。分别于术后 4、8、12、16周 4个时间组 ,取材作组织学观察。临床应用该法治疗 5 0例手指神经瘤性残端痛。结果　光镜观察 ,实验组缝合口处无神经瘤形成 ,再生的神经纤维在腱纤维间隙内生长 ,排列有序。对照组均有神经瘤形成。术后 5 0例中失访 4例 ,46例随访 6个月～ 2年 ,按中日联谊医院的评定标准评定优良率为 91%。结论　神经肌腱缝合法是一种有效的治疗神经瘤性残端痛的新方法。Objective To investigate a new treatment method for neuromatic stump pain. Methods Thirty SD rats were randomly divided into two groups, with 15 in each. In the experimental group, the sciatic nerve was transected at one side. Its proximal end was anastomosed with the proximal end of achilles tendon at the same side. In the control group, the sciatic nerve (1 cm in length) was excised off. The specimens were tested by histology examination on the postoperative weeks 4,8,12,16, respectively. In clinical practice, 50 cases of neuromatic stump pain at the finger had been done with this method. Results There was no formation of neuroma at the site of anastomosis in the experimental group under the light microscope examination. The regeneration of nerve fibers was regularly arranged in the gap of tendon fibers.However, neuromas occurred in the control group. There was 4 cases in loss of follow up, and 46 cases with a period of follow up of 6 months to 2 years. The excellent and good rate was 91% according to the assessment criteria issued by China Japan union hospital. Conclusion Anastomosis of nerve to tendon was an effective and new method for treatment of neuromatic stump pain.

关 键 词：神经肌腱缝合 治疗 残端痛 实验 截肢残端 手部神经瘤 

分 类 号：R739.96[医药卫生—肿瘤] R651.3[医药卫生—临床医学]