摘要
探讨不同术式治疗痛性指固有神经瘤疗效。共30例患者(30指)分别接受神经弓式双端侧神经吻合术(11例)、神经移植端-端吻合术(10例)或直接端-端吻合术(9例)。参照Burchiel等疗效评价标准,神经弓式双端侧神经吻合术组疗效达优9例、良2例,神经移植端-端吻合术组达优4例、良3例、可3例,直接端-端吻合术组达优4例、良4例、可1例,神经弓式双端侧神经吻合术疗效优于其他两种术式(Z=-1.927,P=0.041);测量3种术式组患指两点分辨觉,分别为(5.01±0.71)、(7.30±1.21)和(6.10±1.10)mm,神经弓式双端侧神经吻合术低于其他两种术式(F=3.144,P=0.022)。提示神经弓式双端侧神经吻合术治疗痛性指固有神经瘤的效果优于神经移植或直接端-端吻合术,可有效治疗痛性指固有神经瘤,消除患指疼痛、恢复指腹触摸敏感性。
This paper aims to investigate the curative effect of different surgeries for painful digitalproper neuroma. There were 30 patients with painful digital proper neuroma, among whom 11 patientsunderwent arched double end-to-side neuroanastomosis, 10 patients underwent nerve graft with end-to-endneuroanastomosis, while other 9 patients underwent directly end-to-end neuroanastomosis. The resultsshowed that the two-point discrimination(2-PD) was(5.01 ± 0.71) mm in arched double end-to-sideneuroanastomosis, which was significantly lower than that in nerve graft with end-to-end neuroanastomosis[(7.30 ± 1.21) mm] and directly end-to-end neuroanastomosis [(6.10 ± 1.10) mm; F = 3.144, P = 0.022].According to Burchiel's efficacy, there were 9 excellent and 2 good fingers in arched double end-to-sideneuroanastomosis; 4 excellent, 3 good and 3 fair fingers in nerve graft with end-to-end neuroanastomosis; 4excellent, 4 good and one fair fingers in directly end-to-end neuroanastomosis. The efficacy of the firstgroup was significantly better than those of the other 2 groups(Z=-1.927, P=0.041). The arched nerves ofdouble end-to-side neuroanastomosis is a valuable surgical method for painful digital proper neuroma, whichcan quickly restore the sensation of fingers, and have better outcome than the other two methods.
出处
《中国现代神经疾病杂志》
CAS
2014年第9期824-827,共4页
Chinese Journal of Contemporary Neurology and Neurosurgery
基金
江苏省科技项目(项目编号:BS2007054)
南京军区医药卫生科研基金重点资助项目(项目编号:07Z028)~~
关键词
神经瘤
指损伤
疼痛
顽固性
神经移位
修复外科手术
Neuroma
Finger injuries
Pain,intractable
Nerve transfer
Reconstructive surgical procedures
