Yamashita T, Ishii S, Usui M
Department of Orthopaedic Surgery, Sapporo Medical University, Japan.
J Bone Joint Surg Br. 1998 May;80(3):499-503. doi: 10.1302/0301-620x.80b3.8370.
We performed resection of part of an injured peripheral nerve in 20 patients with post-traumatic neuralgia, after conservative treatment had failed. All had burning pain, paraesthesia and dysaesthesia in the area innervated by the injured nerve. We resected the nerve in the area in which the patient felt pain, and a further 3 cm proximal to the site of injury. In all cases, the local pain disappeared or markedly decreased. The areas of pain relief and of nerve resection coincided completely in 17 patients and partially in three. The results were assessed as excellent by five patients, good by 11, and fair by four. There were no poor results. Histological examination of the resected nerves showed Wallerian degeneration and immunohistochemical tests indicated that substance P, a polypeptide which may contribute to nociceptive transmission, was present in the tissue around the degenerated nerves.
在保守治疗失败后，我们对20例创伤后神经痛患者进行了部分受损周围神经切除术。所有患者在受损神经支配区域均有灼痛、感觉异常和感觉迟钝。我们在患者感到疼痛的区域以及损伤部位近端3厘米处切除神经。在所有病例中，局部疼痛消失或明显减轻。17例患者疼痛缓解区域与神经切除区域完全吻合，3例部分吻合。5例患者评估结果为优，11例为良，4例为中。无差的结果。切除神经的组织学检查显示瓦勒变性，免疫组化检测表明P物质（一种可能参与伤害性传递的多肽）存在于变性神经周围的组织中。
