Matejcík V
Neurochirurgická klinika LFUK, FNsP akad. L. Dérera, Bratislava.
Acta Chir Orthop Traumatol Cech. 2002;69(2):85-7.
The author presents results of 42 surgeries performed by microtechnique in 42 patients within the treatment of 45 nerves in the period of 15 years, i.e. between 1985 and 1999.
Forty-five nerves were reconstructed in 42 patients with a lesion of peripheral nerves of upper limbs by means of autografts.
The efficiency of the surgery was analyzed on the basis of the following indicators: the interval between the injury and surgery, the patient's age, length of autograft, nature of injury, level of injury, type of the injured nerve. In the evaluation we used Sedon's classification of motor and sensitive functions of 1975.
The best results were achieved in young patients up to the age of 20, in timely operations within 3 months, in nerve grafts up to the length of 5 cm. A simple cut wound provides much better conditions for a successful auto-transplantation of a nerve graft as compared to other more complicated injuries (e.g. lacerated wound or contusion).
A timely surgical revision combined with neurolysis and, if need be, with a reconstruction surgery is in indicated cases a decisive factor influencing the outcome of the surgery.
作者介绍了在1985年至1999年的15年间,对42例患者的45条神经进行显微技术手术治疗的42例手术结果。
42例上肢周围神经损伤患者通过自体移植重建了45条神经。
根据以下指标分析手术效果:损伤与手术之间的间隔、患者年龄、自体移植长度、损伤性质、损伤水平、受损神经类型。评估中我们采用了1975年塞登(Sedon)的运动和感觉功能分类法。
20岁以下的年轻患者、3个月内及时进行手术、神经移植长度达5厘米时取得了最佳效果。与其他更复杂的损伤(如撕裂伤或挫伤)相比,单纯切割伤为神经移植自体移植成功提供了更好的条件。
在有指征的病例中,及时的手术翻修结合神经松解术,如有必要,结合重建手术,是影响手术结果的决定性因素。