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移植修复后周围神经恢复潜力的差异。

Difference in recovery potential of peripheral nerves after graft repairs.

作者信息

Roganovic Zoran, Pavlicevic Goran

机构信息

Neurosurgical Department, Military Medical Academy, Belgrade, Serbia and Montenegro.

出版信息

Neurosurgery. 2006 Sep;59(3):621-33; discussion 621-33. doi: 10.1227/01.NEU.0000228869.48866.BD.

Abstract

OBJECTIVE

To our knowledge, few studies have been published regarding differences in nerve recovery potentials. In this study, sensory and motor recovery potentials were compared between different nerves.

METHODS

A prospective study of a homogenous group of 393 graft repairs of the median, ulnar, radial, tibial, peroneal, femoral, and musculocutaneous nerves, with the scoring of motor and sensory recoveries. Sensory and motor recovery potentials, defined on the basis of average scores and rates of useful recovery, were compared between the different nerves, and separately for high-, intermediate-, and low-level repairs.

RESULTS

Sensory recovery potential was similar for all nerves tested (P > 0.05), but motor recovery potential differed significantly. After high-level repairs, motor recovery potential was significantly better for the radial and tibial nerves (useful recovery in 66.7 and 54.5% of patients, respectively), than for the ulnar and peroneal nerves (useful recovery in 15.4 and 13.8% of patients, respectively; P < 0.05). After intermediate-level repairs, motor recovery potential was better for the musculocutaneous, radial, and femoral nerves (useful recovery in 100, 98.3, and 87.5% of repairs, respectively), than for the tibial, median and ulnar nerves (useful recovery in 63.9, 52, and 43.6% of repairs, respectively; P < 0.05). In addition, motor recovery potential was significantly the worst with peroneal nerve repairs (useful recovery in 15.2% of patients; P < 0.05). After low-level repairs, motor recovery potential was similar for all nerves (useful recovery in the range of 88.9-100% of patients and in 56.3% of peroneal nerve repairs).

CONCLUSION

Sensory recovery potential is similar for the median, ulnar, and tibial nerves. The expression of motor recovery potential depends on the repair level. With low- and high-level repairs, it does not stand out in an obvious way, but it is fully expressed with intermediate-level repairs, classifying nerves into three categories with excellent, moderate, and poor recovery potential.

摘要

目的

据我们所知,关于神经恢复潜能差异的研究发表较少。在本研究中,对不同神经的感觉和运动恢复潜能进行了比较。

方法

对393例正中神经、尺神经、桡神经、胫神经、腓总神经、股神经和肌皮神经移植修复的同质组进行前瞻性研究,并对运动和感觉恢复进行评分。根据平均得分和有效恢复率定义的感觉和运动恢复潜能,在不同神经之间进行比较,并分别针对高、中、低水平修复进行比较。

结果

所有测试神经的感觉恢复潜能相似(P>0.05),但运动恢复潜能有显著差异。在高水平修复后,桡神经和胫神经的运动恢复潜能明显优于尺神经和腓总神经(分别有66.7%和54.5%的患者获得有效恢复)(P<0.05)。在中等水平修复后,肌皮神经、桡神经和股神经的运动恢复潜能优于胫神经、正中神经和尺神经(分别有100%、98.3%和87.5%的修复获得有效恢复)(P<0.05)。此外,腓总神经修复后的运动恢复潜能明显最差(15.2%的患者获得有效恢复;P<0.05)。在低水平修复后,所有神经的运动恢复潜能相似(88.9%-100%的患者获得有效恢复,腓总神经修复中有56.3%获得有效恢复)。

结论

正中神经、尺神经和胫神经的感觉恢复潜能相似。运动恢复潜能的表现取决于修复水平。在低水平和高水平修复时,它没有明显突出,但在中等水平修复时能充分表现出来,将神经分为恢复潜能优秀、中等和较差的三类。

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