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创伤性周围神经损伤:诊断与治疗。

Traumatic peripheral nerve injuries: diagnosis and management.

机构信息

Department of Neurology, Hornsby Ku-ring-gai Hospital.

Sydney Medical School, University of Sydney.

出版信息

Curr Opin Neurol. 2022 Dec 1;35(6):718-727. doi: 10.1097/WCO.0000000000001116.

Abstract

PURPOSE OF REVIEW

To review advances in the diagnostic evaluation and management of traumatic peripheral nerve injuries.

RECENT FINDINGS

Serial multimodal assessment of peripheral nerve injuries facilitates assessment of spontaneous axonal regeneration and selection of appropriate patients for early surgical intervention. Novel surgical and rehabilitative approaches have been developed to complement established strategies, particularly in the area of nerve grafting, targeted rehabilitation strategies and interventions to promote nerve regeneration. However, several management challenges remain, including incomplete reinnervation, traumatic neuroma development, maladaptive central remodeling and management of fatigue, which compromise functional recovery.

SUMMARY

Innovative approaches to the assessment and treatment of peripheral nerve injuries hold promise in improving the degree of functional recovery; however, this remains a complex and evolving area.

摘要

目的综述

回顾外伤性周围神经损伤的诊断评估和治疗进展。

最新发现

连续多模态评估周围神经损伤有助于评估自发轴突再生,并选择合适的患者进行早期手术干预。新的手术和康复方法已经被开发出来,以补充既定的策略,特别是在神经移植、靶向康复策略和促进神经再生的干预方面。然而,仍有几个管理挑战,包括不完全神经再支配、创伤性神经瘤的发展、适应性中枢重塑以及疲劳的管理,这些都会影响功能的恢复。

总结

评估和治疗周围神经损伤的创新方法有望提高功能恢复的程度,但这仍然是一个复杂和不断发展的领域。

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