臂丛神经根性撕脱伤患者三叉神经支配区感觉改变与交感神经功能状态关系的探讨

A Study on the Relationship between the Hypoesthesia of Trigeminal Nerves of Cases with Root Avulsion of the Brachial Plexus and the Function of Sympathetic Nerves

目的 :研究臂丛神经根性撕脱伤患者面部三叉神经支配区感觉变化与交感神经功能状态的关系。方法 :对38例臂丛神经根性撕脱伤患者面部三叉神经支配区感觉和交感神经功能状况进行临床检查与分析 ,同时对臂丛神经、膈神经和副神经损伤情况进行电生理学检测。结果 :38例臂丛神经根性撕脱伤患者中 ,19例伴有交感神经损伤 ,13例面部感觉减退。交感神经功能减退的 19例患者中 ,12例伴有面部感觉减退 ( 6 3.2 % ) ;面部感觉减退的 13例患者中 ,12例伴有交感神经功能减退 ( 92 .3% )。臂丛神经根性撕脱伤患者受伤短期内 ,可有患侧头面部交感神经功能和面部感觉减退 ,一段时期以后 ,患侧面部三叉神经支配区感觉可随交感神经症状的消失而逐渐恢复。结论 :臂丛神经根性撕脱伤患者常伴有颈部交感神经损伤 。

Objective: To study the relationship between hypoesthesia of trigeminal nerves of cases with root avulsion of the brachial plexus and the function of sympathetic nerves.Methods:Clinical examinations and analysis of the sensation of trigeminal nerves and the function of sympathetic nerves had been done in 38 cases with root avulsion of the brachial plexus.The injury degree of brachial plexus nerves,phrenic nerves and accessory nerves were examined by physiological test.Results:Of 38 cases of root avulsion of brachial plexus,19 cases accompanied with sympathetic nerves injury and 13 cases accompanied with hypoesthesia of faces.Of 19 cases of sympathetic hypofunction,12 cases accompanied with hypoesthesia of faces (63.2%).Of 13 cases of the hypoesthesia of faces,12 cases accompanied with sympathetic hypofunction (92.3%).In the short period after injury,cases of root avulsion of brachial plexus usually accompanied with sympathetic hypofunction and hyposesthesia of scalp and face in affected side.After a long period,the sensation of trigeminal nerve in affected side could gradually recover with the decrease of the sympathetic symptoms.Conclusions:The cases of root avulsion of brachial plexus usually accompanied with cervical sympathetic nerve injury.The hypoesthesia of trigeminal nerve in affected side face may be related to the cervical sympathetic nerve injury.