利用外固定架进行神经牵引治疗周围神经缺损的疗效观察

The effect observation of nerve traction by external fixator on peripheral nerve defect

目的通过缓慢延长神经的方法治疗大段神经缺损,并与传统的腓肠神经移植进行疗效比较。方法 2016年1月-2018年6月共入选17例周围神经缺损患者,分为观察组8例和对照组9例。观察组采用自制的外固定架对缺损神经进行缓慢延长,每日1 mm,对照组采用传统的腓肠神经移植方式治疗神经缺损。术后1年对比两组BMRC神经功能评定等级以及神经电生理检查,测量修复神经的运动传导速度、运动电位潜伏期及感觉传导。结果两组MBRC功能评价优良率:观察组87.5%,对照组88.9%,两组间无明显差异。观察组的运动神经传导速度(m/s)、运动电位潜伏期(ms)、感觉神经传导速度(m/s)分别为(38.32±3.42)、(6.63±1.15)、(45.34±3.12);对照组为(39.71±3.17)、(6.40±1.25)、(46.75±2.15),两组间无明显差异。结论利用自制的外固定架对大段缺损的周围神经进行牵引可以达到满意的治疗效果,为周围神经缺损的治疗提供了一种新的方法。

Objective The method of slowly extending the nerve was used to treat the large nerve defect,and compared with the traditional sural nerve transplantation. Methods From January 2016 to June 2018,17 patients with peripheral nerve defects were selected and divided into experimental group(8 cases) and control group(9 cases). The experimental group used the self-made external fixator to extend the defect nerve slowly, 1 mm a day. The control group used the traditional sural nerve transplantation to treat the nerve defect. The BMRC nerve function grade and electrophysiological examination were compared between the two groups one year after operation. The motor conduction velocity, motor potential latency and sensory conduction were measured. Results The excellent and good rate of mbrc function evaluation was 87.5% in the experimental group and 88.9% in the control group. The motor nerve conduction velocity(m/s), motor potential latency(m/s) and sensory nerve conduction velocity(m/s) of the experimental group were(38.32±3.42),(6.63±1.15) and(45.34±3.12), respectively, while those of the control group were(39.71 ±3.17),(6.40 ±1.25) and(46.75 ±2.15), respectively. There was no significant difference between the two groups. Conclusion The self-made external fixator can be used to pull the peripheral nerve with large defect to achieve satisfactory therapeutic effect. It provides a new method for the treatment of peripheral nerve defect.