摘要
目的 通过对中、重度肘管综合征的分度及手术效果分析寻找最佳治疗方法。方法 根据3 4例中、重度肘管综合征在手术中发现尺神经的变性程度分为 2组。Ⅰ组 :尺神经无明显神经瘤样变 ,采用前置术加神经鞘膜内注射确炎舒松 A。Ⅱ组 :尺神经在肘管内有明显神经瘤样变 ,采用前置术、束间松解术、神经周围放置确炎舒松 A。结果 术后平均随访 2 2 .2个月。按 2 0 0 0年手外科学会周围神经功能评定试用标准评价 ,Ⅰ组 14例 ,功能恢复优良率为 85 .7%。Ⅱ组 2 0例 ,优良率为 75 %。结论 中、重度肘管综合征在术中如发现尺神经产生瘤样变 ,应同时行神经前置术、神经束间松解术 ,术后神经周围放置确炎舒松 A。
Objective To seek the optimal method for treatment of moderate or severe degree cubital tunnel syndrome.Methods 34 cases with moderate or severe degree cubital tunnel syndrome were divided into two groups according to intraoperative finding of ulnar nerve degeneration: a) group Ⅰ: no neuromatoid change of the ulnar nerve, b) group Ⅱ: obvious neuromatoid change of the ulnar nerve in the cubital tunnel. Group Ⅰ was treated with ulnar nerve anterior transposition and intrathecal injection of HCA. Group Ⅱ was treated by ulnar nerve anterior transposition, interfascicular neurolysis and injection of HCA. Results The patients were followed for an average of 22.2 months. The treatment outcome was evaluated according to the criteria for functional assessment of the peripheral nerve set up by Chinese Hand Surgery Society 2000 issue. The overall excellent and good rate was 85.7 % of the 14 cases in group Ⅰ, and 75 % of the 20 cases in group Ⅱ. Conclusions Ulnar nerve anterior transposition, interfascicular neurolysis and HCA injection is necessary for moderate or severe degree cubital tunnel syndrome with obvious neuromatoid change of the ulnar nerve.
出处
《中华手外科杂志》
CSCD
2000年第3期156-158,共3页
Chinese Journal of Hand Surgery
