Novak C B, van Vliet D, Mackinnon S E
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO, USA.
J Hand Surg Am. 1995 Mar;20(2):221-6. doi: 10.1016/S0363-5023(05)80011-5.
Our study used a telephone survey to evaluate long-term subjective outcome of 70 patients with 112 upper extremity neuromas treated surgically. The mean postinjury time before surgery was 9 years. The mean postsurgical followup was 5 years. Fifty-one of the patients were involved with workers' compensation (WC). Forty-five patients reported good relief of pain. Preoperatively, 46 patients were unemployed because of pain; following surgery 18 of these patients returned to work. Of the 54 patients taking analgesic medication preoperatively, 19 reported less and 10 reported no postoperative analgesic use. No significant difference was found in gender, postinjury time, postsurgical followup time, number of previous surgeries for pain relief, or site of nerve injury between patients who reported improvement versus no symptomatic improvement. Poor subjective outcome occurred in patients (p < .03), with 16 out of 19 of those not involved with WC reporting good pain relief as compared to 29 out of 51 of WC patients.
我们的研究采用电话调查的方式，对70例接受手术治疗的112例上肢神经瘤患者的长期主观预后进行了评估。术前受伤至手术的平均时间为9年。术后平均随访时间为5年。其中51例患者涉及工伤赔偿（WC）。45例患者报告疼痛得到明显缓解。术前，46例患者因疼痛而失业；术后，其中18例患者重返工作岗位。术前服用止痛药物的54例患者中，19例报告术后止痛药物使用减少，10例报告术后无需使用止痛药物。在报告病情改善与未出现症状改善的患者之间，在性别、受伤后时间、术后随访时间、既往为缓解疼痛而进行的手术次数或神经损伤部位方面，未发现显著差异。主观预后较差的情况出现在部分患者中（p < .03），未涉及工伤赔偿的19例患者中有16例报告疼痛得到明显缓解，而涉及工伤赔偿的51例患者中有29例报告疼痛得到明显缓解。
