摘要
应用显微外科技术,修复臂丛神经损伤和重建肩肘功能共33例。膈神经移位治疗颈节前根性撕脱伤4例,术后肱二头肌肌力达Ⅲ级1例;单纯松解术9例:神经移植术4例,术后感觉恢复好,运动肌肉可达Ⅲ级;直接吻合6例;对部分损伤,为防止术后粘连,用自体静脉纵行剖开包裹缺损段神经1例,本组臂丛手术优良率达68.7％。对术后部分功能无恢复者或没有神经修复条件的行斜方肌替代三角肌4例;胸大肌替代肱二头肌3例;肌腱转位替代屈指肌腱2例。作者认为,病程在2年以内者,均可手术探查。由于臂丛神经多半损伤范围广泛,并受各种因素的影响,术后功能往往不能完全恢复。凡无神经修复条件者,应采用多种术式综合修复。
During 1982 to 1987, microsurgical technique was used in the treatment of brachiat plexus injury and reconstruction of the functions of shoulder and elbow joints in 33 cases. The operations were performed in 2 months to 12 years after injury, averaging 25 months. Excellent or good result was obtained in 68.6%. For patients who did not recover or had incomplete recovery after operation, or whose nerves could not be repaired, their deltoideus was replaced by trapezius (4 cases), brachial biceps muscle was replaced by pectoralis major (3 cases), or the flexor tendons were replaced by other tendon transfers (2 cases). All cases with reconstructive operation resumed good functions. The authors believe that attention should be paid to the sequence of recovery in muscle function. If no recovery was demonstrated by electromyography within 2 years, exploration should be carried out.
出处
《上海医学》
CAS
CSCD
北大核心
1990年第9期500-502,共3页
Shanghai Medical Journal
