注射性坐骨神经损伤的手术治疗

Surgical Treatment for Injection Injury of the Sciatic Nerve in Children

目的 提高注射性坐骨神经损伤的疗效。 方法 对 5 6例注射性坐骨神经损伤的患儿采用神经卡压松解、神经外膜内注射醋酸确炎舒松 A ,神经束膜松解 ,坐骨神经周围放置醋酸确炎舒松 A ,术中对坐骨神经直接电刺激等。 结果 术后随访 2年 ,神经损伤症状完全恢复 18例 ,部分恢复 2 7例 ,无明显恢复 11例 ,有效率 80 .4%。 结论注射性坐骨神经损伤一旦有损伤的症状体征 ,应立即手术 ,及早神经外膜松解、生理盐水冲洗及术中对坐骨神经直接电刺激有助于坐骨神经损伤的恢复。醋酸确炎舒松

Objective To improve the therapeutic effect of injection injury of the sciatic nerve. Methods Fifty six children with injection injury of the sciatic nerve were treated with surgical treatment: decompression extraneurolysis, saline irrigation, Triamcindoni Acetonidi Acetatis (TAA) subepineurium injection, eudoneurolysis, TAA topical use and direct electric stimulation of the sciatic nerve. Results At 2 year follow up, complete recovery in 18 cases and partial recovery in 27 cases were achieved and there was no improvement in 11 cases. The effective rate was 80.4%. Conclusions Once if the symptom and signs of injection injury of the sciatic nerve are found, immediate operation is necessary. Early incision of the epineurium with saline irrigation and electric stimulation is good to the recovery of the injuried sciatic nerve. Application of TAA can lessen the adhesion and avoid the scar formation with recompression of the sciatic nerve after the operation.