腕部神经损伤的急诊修复

THE EMERGENT REPAIR OF PERIPHERAL NERVE INJURY OF THE WRIST

目的观察腕部神经损伤后经急诊显微修复的效果。方法１９９３年７月～１９９７年１２月对１７例２１条腕部受伤的周围神经进行急诊显微修复，其中正中神经损伤１１例，尺神经损伤２例，两神经同时受损４例。１条为部分断裂，２０条为完全断裂。用７／０～８／０无创缝线作神经外膜缝合１７条，束膜缝合４条。观察神经功能的恢复。结果术后创面Ⅰ期愈合。经６～１８个月随访，所有患者伤手神经功能恢复优良率达到９５．２５％。结论因腕部结构的特殊性，在该部位的神经损伤后经急诊显微修复，有利于再生神经在最短时间内达到感受器和终板，使手内在肌恢复形态和功能，并减少局部粘连。

Objective To investigate the effect of the emergent repair of peripheral nerve injury of the wrist.Methods From July 1993 to December 1997, 17 cases were admitted, which 21 injuried peripheral nerves were repaired emergently. Among them, there were 11 cases of median nerve injury, 2 cases of ulnar nerve injury and 4 cases of median and ulnar nerve injury. All the nerves were ruptured completely except one which was partially ruptured. The emergent operation was taken and the injuried nerves were repaired by microsurgical technique.Results Followed up 6 to 18 months after operation, 95.25% injuried nerves had good outcome.Conclusion Because of the specific structure of the wrist, nerve injury at this part need to be repaired emergently. It can enhance the regeneration of the injuried nerve, preserve the function of the intrinsic muscle of hand, and decrease the local adhesion.