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神经再支配(奥伯林手术)后光生物调节治疗臂丛神经损伤:一项随机对照试验。

Photobiomodulation After Neurotization (Oberlin Procedure) in Brachial Plexus Injury: A Randomized Control Trial.

机构信息

Department of Orthopaedics and University of Malaya, Medical Centre, Kuala Lumpur, Malaysia.

Department of Rehabilitation Medicine, University of Malaya, Medical Centre, Kuala Lumpur, Malaysia.

出版信息

Photobiomodul Photomed Laser Surg. 2020 Apr;38(4):215-221. doi: 10.1089/photob.2019.4757.

Abstract

To investigate effect of photobiomodulation (PBM) on nerve regeneration after neurotization with the Oberlin Procedure (ulnar fascicle to motor branch to biceps) to restore elbow flexion in patients with brachial plexus injury. This prospective randomized controlled trial was conducted with 14 patients with high brachial plexus injury who underwent neurotization with the Oberlin Procedure to restore elbow flexion. The patients were randomly allocated to two groups of equal numbers: control group and PBM group. In this study, the PBM used has a wavelength of 808 nm, 50 mW power, continuous mode emission, 4 J/cm dosimetry, administered daily for 10 consecutive days, with an interval of 2 days (weekends). The outcome of surgery was assessed after 1, 2, 3, and 6 months. The nonparametric Mann-Whitney -test and chi-square test were utilized to compare the results between both groups. After 3 months postoperatively, more patients in the PBM group had demonstrated signs of reinnervation and the mean muscle power was significantly higher in the PBM group. No adverse effects resulted from the administration of PBM. PBM is a treatment modality that can improve nerve regeneration after neurotization with the Oberlin Procedure.

摘要

为了研究光生物调节(PBM)对应用 Oberlin 手术(尺神经束支转位至肱二头肌肌支)进行神经再支配后神经再生的影响,以恢复臂丛神经损伤患者的肘部屈曲功能。这是一项前瞻性随机对照试验,共纳入 14 例接受 Oberlin 手术进行神经再支配以恢复肘部屈曲功能的高位臂丛神经损伤患者。患者随机分为两组,每组各 7 例:对照组和 PBM 组。在这项研究中,使用的 PBM 的波长为 808nm,功率为 50mW,连续模式发射,剂量为 4J/cm,每天治疗 10 天,间隔 2 天(周末)。术后 1、2、3 和 6 个月评估手术结果。采用非参数曼-惠特尼 U 检验和卡方检验比较两组结果。术后 3 个月时,PBM 组更多患者出现神经再支配迹象,且 PBM 组的平均肌肉力量明显更高。PBM 的应用未产生不良反应。PBM 是一种治疗方式,可改善 Oberlin 手术神经再支配后的神经再生。

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