侧侧神经吻合术治疗高位周围神经损伤。
Side-to-side neurorrhaphy for high-level peripheral nerve injuries.
机构信息
Orthopedics Department, Changhai Hospital, 168 Changhai Road, Shanghai, China.
出版信息
Acta Neurochir (Wien). 2012 Mar;154(3):527-32. doi: 10.1007/s00701-011-1264-2. Epub 2012 Jan 5.
BACKGROUND
The results of peripheral nerve repair, especially for high-level peripheral nerve injuries, have been unsatisfactory. The method of side-to-side neurorrhaphy was developed in our laboratory from 1994 to 2002. This method involves suturing the injured nerve to a nearby donor nerve in a side-to-side manner. This study was performed to assess the clinical results of side-to-side neurorrhaphy in patients with high-level peripheral nerve injuries.
METHODS
Twenty-five patients with various types of high-level peripheral nerve injuries who underwent side-to-side neurorrhaphy were studied. The British Medical Research Council (BMRC) scale was used to assess recovery of nerve function.
RESULTS
Average follow-up duration was 3.2 years. Before surgery the patients had a nerve function of M0/S0 to M1/S1. After side-to-side neurorrhaphy, 7 patients had a score of M3/S4, 8 patients a score of M3/S3 and 10 patients a score of M2/S3. The total useful recovery rate (BMRC grade ≥3) was 60% for motor function and 100% for sensory function. Side-to-side neurorrhaphy did not result in any significant loss of donor nerve function. There was significant correlation between both the type of injury and the time interval between injury and surgery and motor nerve function. Age, gender and location of the injured nerve did not correlate with sensory or motor nerve function.
CONCLUSION
Side-to-side neurorrhaphy appears to be promising as a feasible method for repair of high-level peripheral nerve injuries.
背景
周围神经修复的效果，尤其是高水平周围神经损伤的修复效果，一直不尽如人意。侧侧吻合术是我们实验室于 1994 年至 2002 年开发的一种方法，涉及将损伤的神经与附近的供体神经以侧侧的方式缝合。本研究旨在评估侧侧吻合术治疗高水平周围神经损伤患者的临床效果。
方法
研究了 25 例接受侧侧吻合术的不同类型高水平周围神经损伤患者。采用英国医学研究理事会（BMRC）量表评估神经功能恢复情况。
结果
平均随访时间为 3.2 年。手术前，患者的神经功能为 M0/S0 至 M1/S1。侧侧吻合术后，7 例患者评分为 M3/S4，8 例患者评分为 M3/S3，10 例患者评分为 M2/S3。运动功能的总有效恢复率（BMRC 分级≥3）为 60%，感觉功能为 100%。侧侧吻合术没有导致供体神经功能明显丧失。损伤类型和损伤与手术时间间隔与运动神经功能显著相关。年龄、性别和损伤神经的位置与感觉或运动神经功能无关。
结论
侧侧吻合术似乎是一种很有前途的治疗高水平周围神经损伤的可行方法。
Zotero 插件