神经束间侧侧缝合重建截瘫/四肢瘫感觉功能

Functional Reconstruction of Sensation in Paraplegia with side to Side Suture Interfascicular of Peripheral Nerves

目的 :介绍一种重建截瘫 /四肢瘫部分感觉功能的新方法。方法 :选择具有感觉功能的神经干或束组作为供体神经 ,支配感觉消失区的神经干或束组为受体神经 ,在合适的平面将两神经的束外膜切开约 1～ 1.5cm ,相互紧密并拢后以 9～ 10个“0”无损伤针线侧侧缝合束外膜。结果 :2 1例 (四肢瘫 4例 ,截瘫 17例 )术后获 1～ 5年 (平均 2年 8个月 )的随访 ,3例失访。受区感觉恢复达S3级者 11例 ,S2级者 6例 ,S1级者 2例。但重建感觉区域的感觉定位均转换较差。结论 :周围神经侧侧缝合可以重建截瘫、四肢瘫患者的部分感觉功能。

Objective: To introduce a new approach to sensory function reconstruction for paraplegia or tetraplegia.Methods: Twenty one patients with paraplegia (17) or tetraplegic(4) were involved in this study,whose nerve stem or fascicle group with normal sensory function was selected as donor nerve,while that innervating areas without sense as acceptor nerve.At the proper level,epineurium and perineurium of two nerves were cut open about 1cm to 1.5cm ,and exposed parts of two nerves were put together,then the opend epineurium and perineurium were stutured side to side with 9 10 '0' thread.Results: Twenty one patients were followed up 1 to 4 years (2 years average)postoperatively,3 were lost.among them,sensory function of the receptor areas of 11 patients restored to grade S3,6 patients to grade S2 and 2 patients to grade S1.But transfer of sense localization of the sensory reconsturction areas was poor,Conclusion: Partial sensory function reconstruction can be achieved through side to side neurorrhaphy of peripheral nerves in patients with paraplegia or tetraplegia.