神经膜内迟发性受压综合症的外科治疗

目的探讨神经干膜内迟发进行性神经卡压综合症的临床特点和治疗方法。方法对神经干连续性存在,而有神经膜内神经瘤或瘢痕形成的病例进行显微外科手术切除与重建治疗。结果因神经膜内假性神经瘤或瘢痕卡压导致的症候群,在术后数小时至6周内得到解除,平均为2周。对神经纤维不同程度损伤所致假性神经瘤,经切除后,做神经移植修复病例,依据修复神经平面不同,在术后3～12个月获得恢复,平均恢复时间6个月。结论神经膜内假性神经瘤,有部分神经纤维实质性损伤的早期临床特点,还有随着损伤神经纤维假性神经瘤形成,对存留神经纤维产生继发性卡压症状与体症。通过病例分析,有利于辨别神经实质损伤与继发的内在神经压迫,为手术提供依据。

Objective In the goal discussion nerve dry film the hang fire carries on the nerve card to press the syndrome the clinical characteristic and the method of treatment.Methods To nerve dry continuity existence,but has the case which in the neurilemma the neuronal or the scar form to carry on the microsurgery surgery excision and the reconstruction treatment.Results Because in the neurilemma the pseudo neuronal or the scar card pressure causes the syndrome,obtains in from the technique latter several hours to 6 weeks relieves,is 2 weeks equally.To nerve fiber varying degree damage result pseudo neuronal,after excision, makes the nerve transplant repair case,the basis repair nerve plane is different,obtains the restoration in the technique latter 3～12 months,restores the time 6 months equally.Conclusion Neurilemma pseudo neuronal,has the part of nerve fiber substantive damage early clinical characteristic,but also has along with the damage nerve fiber pseudo neuronal formation,to preserves the nerve fiber to produce the sequential card to press the symptom and the body sickness.Analyzes through the case,is advantageous to the distinguishable nerve essence damage with following the intrinsic nerve oppression which sends,provides the basis for the surgery