臂丛神经根对手指感觉的支配

SENSATION OF FINGERS INNERVATED BY BRACHIAL PLEXUS ROOTS

目的探讨臂丛神经根对手指感觉的支配,为临床诊断臂丛神经根损伤提供依据。方法2003年6月～2005年1月,收治全臂丛神经根性撕脱伤患者10例,男8例,女2例;年龄18～47岁。受伤至就诊时间为2～8个月。均行健侧C7神经根移位术,术中行电生理检查。指环电极置于手指,依次在颈部各臂丛神经根记录,测定感觉动作电位潜伏期和波幅。结果刺激拇、食指,臂丛各神经根均可引出感觉动作电位,C5-7神经根引出的感觉动作电位潜伏期短于C8、T1神经根,波幅大于C8、T1神经根,差异有统计学意义（P〈0.05）;刺激中指,C7、8、T1神经根可引出感觉动作电位,C7神经根引出的感觉动作电位潜伏期短于C8、T1神经根,波幅大于C8、T1神经根,差异有统计学意义（P〈0.01）;刺激环指,C8、T1神经根引出的感觉动作电位潜伏期短于C7神经根,波幅大于C7神经根,差异有统计学意义（P〈0.01）;刺激小指,T1神经根引出的感觉动作电位潜伏期短于C7、8神经根,波幅大于C7、8神经根,差异有统计学意义（P〈0.01）。结论臂丛神经根对手指感觉的支配存在交叉,拇、食指主要由C5-7神经根支配;中指的感觉支配较多来自C7神经根;环指的感觉支配主要来自C8、T1神经根;小指的感觉支配主要来自T1神经根。

Objective To investigate the sensation of the fingers innervated by the brachial plexus roots and provide the theoretic basis for diagnosis of a brachial plexus injury. Methods From June 2003 to January 2005,10 patients （8 males, 2 females; age, 18-47 years） with complete brachial plexus avulsion were involved in this study, who underwent the contralateral C7 nerve root transfer. The latency and amplitude of the sensory nerve action potential （SNAP） were record at the C5-T1 nerve roots when stimulation was given at the fingers. Results When the thumb and the index finger were stimulated and SNAP was recorded at all the roots of the brachial plexus in all the patients, we found that there was a higher amplitude and a shorter latency at the C5-7 roots than at the C8 and T1 roots（P〈0.05）. When the middle finger was stimulated and SNAP was recorded at the C7.8 and T1 roots, we found that there was the highest amplitude and the shortest latency at the C7 root（P〈0.01）. When the ring finger was stimulated and SNAP was recorded at the C7.8 and T1 roots, we found that there was a higher amplitude and a shorter latency at the Ca and T1 roots than at the C7 root（P〈0.01）. When the little finger was stimulated and SNAP was recorded at the C7.8 and T, roots, we found that there was the highest amplitude and the shortest latency at the T1 root （P〈0.01）. Conclusion The sense of the thumb and the index finger is mainly innervated by the C5-7 roots, the middle finger sense is mainly innervated by the C7 root, the ring finger sense is mainly innervated by the Ca and T1 roots, and the little finger sense is mainly innervated by the T1 root.