急诊行腕部尺神经损伤修复疗效研究

Clinical curative effects of emergency repairing on ulnar nerve injury of wrist

目的 探讨腕部尺神经损伤急诊修复的临床疗效和价值。方法 回顾性分析2016年6月至2018年12月外伤所致的腕部尺神经损伤患者60例,根据患者病情分为急诊组和择期组,每组30例。2组均行神经束膜修复术修复尺神经,急诊组在入院后8 h内行急诊手术,择期组为伤后约3月就诊手术,对比观察2组患者治疗效果,尺神经传导速度及复合肌肉动作电位波幅。结果 2组患者治疗1年后评估患者治疗效果,与择期组比较,急诊组优良率显著高于择期组(P<0.05)。分别于3个月、6个月、12个月评估两组患者尺神经传导速度与复合肌肉动作电位波幅,与择期组比较,急诊组尺神经传导速度与复合肌肉动作电位波幅均显著优于择期组(P<0.05)。结论 腕部尺神经损伤后急诊手术修复神经具有更佳的临床疗效,推荐在患者病情允许,伤口条件好的情况下,尽快予手术修复神经。

Objective To investigate the curative effects of emergency repairing on ulnar nerve injury of wrist.Methods The clinical data about 60 patients with ulnar nerve injury caused by trauma who were treated in our hospital from June 2016 to December 2018 were retrospectively analyzed.These patients randomly divided into emergency group (n=30) and elective operation group (n=30).The patients in emergency group were treated by emergency operation within 8 hours after admission,and the patients in selective operation group were treated by surgery during 3~6 months after injury. The therapeutic effects,ulnar nerve conduction velocity and amplitude of compound muscle action potential were observed and compared between the two groups.Results The therapeutic effects at one year after treatment in emergency group were superior to those in elective operation group (P<0.05).Moreover the ulnar nerve conduction velocity and the amplitude of compound muscle action potential at 3m,6m,12m after surgery in emergency group were superior to those in elective operation group (P<0.05).Conclusion The therapeutic effects of emergency surgery are superior to those by elective operation,therefor ,it is recommended to repair nerve as soon as possible when the patient’s condition is allowed and the wound condition is better.