超声在外周神经缝合后再生检测中的作用

The role of ultrasonography in detection of early regeneration after peripheral nerve repair

目的初步探讨超声检测在判断外周神经缝合后早期再生中的作用。方法对8例共13条神经在首次缝合术后平均3个月,因临床检查和电生理检测均提示神经断裂或严重受损而再次入院的患者。术前对所有缝合神经进行超声检测,观察、记录神经缝合口声像特征,判断神经束通过缝合口的状况,并与电生理进行比较。结果超声检出13条神经缝合口,根据声像特征将神经束通过缝合口情况分为二级对应术中电生理,超声符合率为92.3%。结论神经再生早期超声可能早于电生理检测判断再生神经的质量。在术后3个月内超声对缝合口神经束通过情况有较高的分辨率。

Objective To investigate the role of ultrasonography in detemaining early regeneration of sutured peripheral nerve. Methods A total of 13 nerve repairs in 8 patients were studied. Neurorrhaphy was done 3 months ago on average. Clinical examination and electromyography（EMG） showed poor recovery and decision of secondary surgical exploration was made. Ultrasonograph of all the nerves was obtained by a single sonographer. The specific image of suture site was recorded, and correlated with intraoperative findings and EMG to calculate accuracy. Results Ultrasonograph was able to locate all 13 suture sites correctly. The status of the repair site covered 2 grades. Correlating with intraoperative EMG, the accuracy of ultrasonography was 92.3%. Conclusion In early period of nerve regeneration, uhmsonography may help to detennine the quality of nerve regeneration prior to EMG. Uhrasonography has decent accuracy in appreciating the status of nerve repair with 3 months after the operation.