四肢周围神经战伤的外科治疗。

STATE INSTITUTION "ROMODANOV NEUROSURGERY INSTITUTE OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE", KYIV, UKRAINE.

STATE INSTITUTION "THE INSTITUTE OF TRAUMATOLOGY AND ORTHOPEDICS BY THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE", KYIV, UKRAINE.

Wiad Lek. 2021;74(3 cz 2):619-624.

OBJECTIVE

The aim: Improving the effectiveness of patients' treatment with combat injuries of the peripheral nervous system, which consists in the application and development of new methods of reconstructive interventions, optimizing a set of therapeutic and diagnostic measures for the most effective management of this category of patients with peripheral nerve injury.

PATIENTS AND METHODS

Materials and methods: The research is based on the results of surgical treatment of 138 patients with combat injuries of peripheral nerves for the period from 2014 to 2020. The mean age was 33.5 ± 2.1 years. Patients were treated for 1 to 11 months after injury (median - 8 months). Damage to the sciatic nerve was observed in 26.1%, ulnar - in 20.3%, median - in 18.8%, radial - in 15.9%, tibial - in 10.9%, common peroneal nerve - in 8% of cases.

RESULTS

Results: It was shown that in all patients was significantly improved the recovery of all nerves. In the period from 9 to 12 months, the degree of recovery of motor function to M0-M2 was observed in 40.6%, to M3 - in 35.5%, to M4 - in 16.7%, to M5 - in 7,2%. The degree of recovery of sensitivity to S0-S2 was observed in 36.2%, to S3 - in 42.8%, to S4 - in 17.4%, to S5 - in 3.6%. Regression of pain syndrome after surgery was observed in 81.2% of patients.

CONCLUSION

Conclusions: The results of surgical treatment of peripheral nerves gunshot injury are generally worse than other types of nerve injuries. The best results of surgical treatment of combat trauma of peripheral nerves are obtained in patients with sciatic nerve damage.

目的

提高外周神经战伤患者的治疗效果，方法为应用和发展新的重建干预方法，优化治疗和诊断措施，以有效管理此类外周神经损伤患者。

患者和方法

研究基于 2014 年至 2020 年期间 138 例外周神经战伤患者的手术治疗结果。患者平均年龄为 33.5 ± 2.1 岁。伤后 1 至 11 个月（中位数 8 个月）接受治疗。26.1%观察到坐骨神经损伤，20.3%观察到尺神经损伤，18.8%观察到正中神经损伤，15.9%观察到桡神经损伤，10.9%观察到胫神经损伤，8%观察到腓总神经损伤。

结果

所有患者的所有神经恢复均明显改善。9 至 12 个月时，观察到运动功能恢复至 M0-M2 的程度为 40.6%，M3 为 35.5%，M4 为 16.7%，M5 为 7.2%。感觉恢复至 S0-S2 的程度为 36.2%，S3 为 42.8%，S4 为 17.4%，S5 为 3.6%。术后疼痛综合征消退 81.2%。