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创伤后周围神经的修复方法:一项系统的文献综述

Repair methods in peripheral nerves after traumatic injuries: a systematic literature review.

作者信息

Costa Naely Nobre, Santos Jennifer Ferreira Dos, Aranha Maria Fernanda de Almeida Cavalcante, Coelho Erik William Farias, Paes Victor Leno Silva, Oliveira Rita de Cássia Silva de

机构信息

Universidade do Estado do Pará - Medical School - Belém (PA) - Brazil.

出版信息

Acta Cir Bras. 2025 Feb 24;40:e401225. doi: 10.1590/acb401225. eCollection 2025.

Abstract

PURPOSE

To identify and describe the most used surgical repair methods for traumatic injuries to peripheral nerves, as well as highlight the causes of trauma to peripheral nerves and the most prevalent traumatized nerves.

METHODS

This is a systematic literature review using the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The searches were carried out in PubMED, in the time window from January 2018 to December 2022.

RESULTS

In total, 3,687 articles were collected, of which, after applying the inclusion and exclusion filters and analyzing the risk of bias, 34 articles remained. It was observed that the age of the injury and type of nerve repair strongly influence the recovery of patients. The most identified trauma repair procedures were neurolysis, direct suturing, grafting, and nerve transfer. Among these four procedures, direct suturing is currently preferred.

CONCLUSION

Several repair methods can be used in peripheral nerve injuries, with emphasis on direct suturing. However, nerve transfer proves to be a differential in those cases in which repair is delayed or the first treatment options have failed, which shows that each method will be used according to the indication for each case.

摘要

目的

识别并描述用于周围神经创伤性损伤的最常用手术修复方法,同时强调周围神经创伤的原因以及最常受损伤的神经。

方法

这是一项采用系统评价与Meta分析的首选报告项目(PRISMA)建议的系统文献综述。检索在2018年1月至2022年12月的时间范围内在PubMed中进行。

结果

共收集到3687篇文章,其中,在应用纳入和排除筛选标准并分析偏倚风险后,剩余34篇文章。观察到损伤年龄和神经修复类型对患者的恢复有强烈影响。最常确定的创伤修复程序是神经松解术、直接缝合、移植和神经移位。在这四种程序中,目前首选直接缝合。

结论

周围神经损伤可采用多种修复方法,重点是直接缝合。然而,如果修复延迟或首选治疗方案失败,神经移位在这些情况下被证明是一种不同的方法,这表明每种方法将根据每个病例的指征使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c50e/11849802/359feada9b39/1678-2674-acb-40-e401225-gf01.jpg

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