吻合血管的腓肠神经移植修复前臂远端尺动脉和尺神经缺损

Repair of defects of distal ulnar artery and nerve of forearm with grafting of vascular sural nerve

目的探讨吻合血管的腓肠神经移植术的临床治疗效果。方法自1998年5月～2001年10月,应用吻合小隐静脉的腓肠神经移植修复低位尺神经尺动脉缺损97例。结果所有患者随访6～84个月,参考Clawson和Seddon氏评价标准,优良率80.41%,其中急诊手术患者优良率为89.74%,Ⅱ期手术优良率为74.14%。结论吻合小隐静脉的腓肠神经移植术是修复前臂远端尺动脉和尺神经缺损的有效方法。神经血管切取方便、操作简单、切取范围大、神经较粗、可折叠。颠倒吻合血管后可同时修复动脉,改善肢体血供,能防止神经坏死,有利于神经修复,疗效肯定。

Objective To investigate clinical effects of g rafting of vascular sural nerve.Methods From1998to 2003,97cases of the defects o f the distal ulnar artery and nerve we re repaired by grafting of sural nerv e with anastomosis of short saphenous vein.Results All the cases were followed up for 6to24months.They were e-valuated according to the modified S eddon rating system.The total excellent and good rate was 80.41%.The ex-cellent and good rate of the emergency cases was 89.74%,while the excelle nt and good rate of second operation was74.14%.Conclusions Grafting of sural nerve with anastom osis of short saphenous vein is an effective method to repair the defects of distal ulnar artery and nerve of the forearm,because the procedure is easy,the nerve and vein are widely available,and the nerve is th ick enough to be foldable.The artery can be repaired after reverse vascul ar anastomosis so as to improve the bloo d circulation of limbs and prevent nerve necrosis.[