健侧C_7神经移位术后早期观察健手感觉运动的动态变化及其临床意义

The regular pattern of early sensory and motor changes of the healthy hand after C_7 transfer and its clinical significance

研究健侧C_7神经移位术后对健手感觉、运动的动态变化规律及临床意义。方法:对30例C_7移位术后早期出现的示、中、拇指及全手感觉异常的面积、握力和捏力的变化,进行动态学分析。结果:示指感觉影响的程度最大。感觉影响的动态变化趋势可分为扩大期、稳定期、消退期和代偿期。每期均有一定的时限。前3期的变化与创伤后反应的演变过程相一致。术后早期握力暂时下降,但捏力无明显影响。结论:术前、术中、术后应重视并采用保护近端神经元、减少创伤反应的措施,尽量缩短创伤反应期,促使代偿期的早日到来。

Objective:To investigate the regular pattern of sensory and motor changes of the healthy hand afterC7 transfer, and figure out its clinical significance. Methods: 30 cases of C7 transfer were carefully examined in the early postoperative period about the sensation of the thumb ,index and long finger, and the pinch strength and grip strength of the healthy hand. Image analysis system was applied to measure the area with sensory abnormality. Results : The sensation of the index finger was most obviously affected. The regular pattern of sensory change was dynamically divided into 4 stages: progressive stage, stable stage, recession stage and compensation stage. The reaction of the first 3 stages was in concordant with the postoperative traumatic reaction. There was a temporary decrease in the grip strength while the pinch strength remained unaffected. Conclusions: Intra and postoperative measures should be taken to protect the proximal neurons and alleviate traumatic reaction.