He Chun-Qing, Zhang Li-Hai, Liu Xian-Fei, Tang Pei-Fu
Department of Orthopedics, Chinese PLA General Hospital, Beijing, China.
Neural Regen Res. 2015 Feb;10(2):252-9. doi: 10.4103/1673-5374.152379.
We performed a 2-year follow-up survey of 523 patients with peripheral nerve injuries caused by the earthquake in Wenchuan, Sichuan Province, China. Nerve injuries were classified into three types: type I injuries were nerve transection injuries, type II injuries were nerve compression injuries, and type III injuries displayed no direct neurological dysfunction due to trauma. In this study, 31 patients had type I injuries involving 41 nerves, 419 had type II injuries involving 823 nerves, and 73 had type III injuries involving 150 nerves. Twenty-two patients had open transection nerve injury. The restoration of peripheral nerve function after different treatments was evaluated. Surgical decompression favorably affected nerve recovery. Physiotherapy was effective for type I and type II nerve injuries, but not substantially for type III nerve injury. Pharmacotherapy had little effect on type II or type III nerve injuries. Targeted decompression surgery and physiotherapy contributed to the effective treatment of nerve transection and compression injuries. The Louisiana State University Health Sciences Center score for nerve injury severity declined with increasing duration of being trapped. In the first year after treatment, the Louisiana State University Health Sciences Center score for grades 3 to 5 nerve injury increased by 28.2% to 81.8%. If scores were still poor (0 or 1) after a 1-year period of treatment, further treatment was not effective.
我们对中国四川省汶川地震导致的523例周围神经损伤患者进行了为期2年的随访调查。神经损伤分为三种类型:I型损伤为神经横断伤,II型损伤为神经压迫伤,III型损伤无因创伤导致的直接神经功能障碍。本研究中,31例患者为I型损伤,累及41条神经;419例为II型损伤,累及823条神经;73例为III型损伤,累及150条神经。22例患者存在开放性横断性神经损伤。评估了不同治疗方法后周围神经功能的恢复情况。手术减压对神经恢复有积极影响。物理治疗对I型和II型神经损伤有效,但对III型神经损伤效果不明显。药物治疗对II型或III型神经损伤效果甚微。针对性减压手术和物理治疗有助于有效治疗神经横断伤和压迫伤。路易斯安那州立大学健康科学中心的神经损伤严重程度评分随被困时间延长而下降。治疗后的第一年,3至5级神经损伤的路易斯安那州立大学健康科学中心评分提高了28.2%至81.8%。如果治疗1年后评分仍较差(0或1分),进一步治疗则无效。