Piza-Katzer H, Herczeg E, Balogh B, Berger R
Abteilung für Plastische und Wiederherstellungschirurgie, Krankenhaus Lainz, Wien.
Nervenarzt. 1994 Jun;65(6):375-80.
Injuries to the central or peripheral nerves caused by medical intervention are called iatrogenic nerve lesions. The caudal relationship between medical intervention and iatrogenic nerve injuries is frequently not very clear. Careful pre- and post-operative examination of the patient, however, will in most instances reveal a nerve lesion in a timely manner. Iatrogenic nerve lesions in the clinical cases available to us were predominantly due to indirect influences, such as pressure, insertion of a retractor or heat; we discovered that only in a few cases a nerve was partially or completely severed or damaged by the material used for osteosynthesis. The pre- and postoperative clinical neurological and electrophysiological examinations of our patients were performed by a neurologist. Nerve-repair was achieved by neurolysis in 19 cases; a primary or secondary suture was performed in three cases. A nerve graft was used in five cases to regain continuity. Those patients (nearly 75%) who underwent restitutive surgery within an six-month period after iatrogenic injury in the primary operation were treated successfully. These results suggest that timely treatment is decisive for good outcome.
由医疗干预导致的中枢或周围神经损伤被称为医源性神经损伤。医疗干预与医源性神经损伤之间的因果关系往往不是很明确。然而，对患者进行仔细的术前和术后检查，在大多数情况下能够及时发现神经损伤。在我们所掌握的临床病例中，医源性神经损伤主要是由间接影响造成的，如压迫、牵开器的插入或热损伤；我们发现只有少数情况下神经会被用于骨合成的材料部分或完全切断或损伤。我们患者的术前和术后临床神经学及电生理检查由一名神经科医生进行。19例患者通过神经松解术实现了神经修复；3例进行了一期或二期缝合。5例使用了神经移植来恢复神经连续性。那些在初次手术医源性损伤后6个月内接受恢复性手术的患者（近75%）得到了成功治疗。这些结果表明，及时治疗对于良好的预后起着决定性作用。
