36例小儿臀部肌肉注射后坐骨神经损伤的临床分析

Clinical analysis of sciatic nerve lesion caused by intramuscular injection in 36 children

目的：探讨对肌肉注射后坐骨神经损伤的最佳诊断、鉴别诊断方法和治疗，以减少误诊和后遗症。方法：对３６例患儿进行神经传导速度和病源学检查，并通过脑脊液、头颅或脊柱ＭＲＩ除外引起的单瘫的其它疾病。结果：临床症状出现的时间大多在肌注后两天内，其症状有注射部位及同侧肢体感觉障碍、肢体少动或跛行、足下垂或内翻、肌肉萎缩、注射局部包块。神经传导速度检查异常。２例肠道病毒阳性。康复治疗与手术治疗相比，平均显效时间明显延长。结论：神经传导速度检查是一种对肌注所致坐骨神经损伤的诊断、鉴别诊断十分有效的检查方法。康复治疗对发病越早者效果越明显。手术患儿恢复较理想。

Objective：This study is aimed to investigate the better methods of the diagnosis,identification and therapy to t he sciatic nerve lesion due to intramuscular injection.Methods： A total of 36 cases of sciatic nerve lesion resulting from intramuscular injection were confirmed by the nerve conduction velocity (NCV)test and pathogenic test.Results：The clinical manifestations often occurred wi thin 2 days after intramuscular injection,which were disturbance of sensation in the injection spot and the lower limbs,hypokinesia of the limbs or claudication,pigeon-toed abnormality,muscular atrophy and a local bump in the injection spot. The NCV tests were abnormal.The pathogenic tests of 2 cases were positive for intestinal virus.The mean recovery time is remarkably delayed in rehabilitation as compared with surgery.Conclusion:The NCV test is an effective method for the diagnosis and identification of the sciatic nerve lesion due to intramuscular injection.Surgical treatment is more efficient than rehabilitation and the rehabilitation is effective for those who had early onset of the symptoms.