汶川地震转运部分伤员闭合性周围神经损伤的早期治疗

Initial treatment for patients transported from the Wenchuan earthquake stricken area suffering closed peripheral nerve injury

目的总结汶川地震转运我院的合并闭合性周围神经损伤患者的早期治疗方法与初期疗效。方法收集21例汶川地震所致闭合性周围神经损伤的临床资料,分析其受伤机制,总结早期治疗方法及初步疗效。结果所有患者均于伤后2月随访,桡神经、尺神经、闭孔神经损伤恢复较好,腓总神经、股神经、坐骨神经次之,腰骶丛、部分臂丛、正中神经损伤恢复较差,1例股神经和1例腓总神经损伤因保守治疗无效采取手术探查松解。结论地震致闭合性周围神经损伤多为挤压或压迫时间过长所致,早期及时进行正规的综合治疗,预后一般较好;对部分压迫伤较重、压迫时间较长、神经损伤较重者,应积极进行手术松解。

Objective To summarize and review the early stage treatment and the initial curative effects of the closed peripheral nerve injury suffered by some patients transported from the Wenehuan earthquqke stricken area. Methods A total of 21 eases suffering from closed peripheral nerve injury caused by Wenehuan earthquake were admitted to our hospital. The clinical data were collected, the injury mechanism was analyzed and the early stage treatment and the initial curative effects were summarized retrospectively. Results All the patients were followed up 2 months after injury. Patients suffering radial nerve, ulnar nerve and obturator nerve injury recovered well ,that of femoral nerve and sciatic nerve injury was fair, lumbosaeral plexus, partial braehial plexus and median nerve injury was poor. The conservative therapy did not work on 2 patients （ one with femoral nerve injury and the other sciatic nerve injury） ,which led to operative exploration. Conclusion The closed peripheral nerve injury results from earthquake, which is regularly caused by crushing and long-time compression, recovere well if it is treated in time by combined and regular way. Those who suffer a long-time compression or a severe nerve injury should be explored operatively in time.