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上肢神经损伤——预期结果与临床检查

Nerve injuries of the upper extremity-expected outcome and clinical examination.

作者信息

Lohmeyer Jörn A, Sommer Bianca, Siemers Frank, Mailänder Peter

机构信息

Department of Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.

出版信息

Plast Surg Nurs. 2009 Apr-Jun;29(2):88-93; quiz 94-5. doi: 10.1097/01.PSN.0000356867.18220.73.

Abstract

Nerve injuries are common in trauma surgery and appear more frequently if the upper extremity is affected. The aim of this study is to estimate possible predictors of the outcome after nerve injury of the upper extremity and to demonstrate feasible tools to follow up postoperative nerve regeneration for the daily clinical practice. During January 2000 until December 2004, a total of 372 nerve lesions of the upper extremity have been treated in our clinic. Patient's age, site of nerve lesion, concomitant injuries, and the timing of surgical repair could be outlined to be significant predictors for clinical outcome. Digital nerve lesions showed the best regenerative capacity. Most predictors of clinical outcome such as patient's age, concomitant injuries, and site of lesion cannot be influenced. But knowing the predictors helps specify the prognosis of nerve regeneration. For the daily clinical practice, static two-point discrimination, location of Tinel's sign, and grip strength measurement seem to be fast and reproducible tools to follow up nerve regeneration at the upper extremity.

摘要

神经损伤在创伤外科中很常见,如果上肢受到影响则更频繁出现。本研究的目的是评估上肢神经损伤后可能的预后预测因素,并展示在日常临床实践中用于随访术后神经再生的可行工具。在2000年1月至2004年12月期间,我们诊所共治疗了372例上肢神经损伤。患者年龄、神经损伤部位、合并损伤以及手术修复时机被确定为临床预后的重要预测因素。指神经损伤显示出最佳的再生能力。大多数临床预后预测因素,如患者年龄、合并损伤和损伤部位,无法受到影响。但了解这些预测因素有助于明确神经再生的预后。对于日常临床实践,静态两点辨别觉、Tinel征位置和握力测量似乎是用于随访上肢神经再生的快速且可重复的工具。

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