神经束膜吻合术与神经外膜吻合术治疗尺神经损伤的效果比较

Comparison of postoperative results between perineurial suturing and epineural suture in the treatment of ulnar nerve injury

目的比较神经束膜吻合术和神经外膜吻合术治疗腕部尺神经损伤的效果。方法将80例腕部尺神经断裂伤患者按治疗方法分为神经束膜吻合组(42例)与神经外膜吻合组(38例)。比较两组患者术后尺神经传导速度、复合肌肉动作电位波幅和临床疗效。结果患者均获得12个月随访。术后3、6、12个月,尺神经传导速度、复合肌肉动作电位波幅神经束膜吻合组明显优于神经外膜吻合组(P<0.001)。术后12个月临床疗效优良率神经束膜吻合组(81.0%)高于神经外膜吻合组(47.4%)(P<0.05)。结论神经束膜吻合术治疗腕部尺神经损伤的效果优于神经外膜吻合术。

Objective To investigate the efficacy of perineurium anastomosis and epineurium anastomosis for treatment of the ulnar nerve injury in the wrist.Methods Eighty patients with ulnar nerve ruptures in the wrist were randomly divided into perineurium anastomosis group(n=42)and epineurium anastomosis group(n=38).The ulnar nerve conduction velocity,compound muscle action potential amplitude and clinical efficacy were compared between the two groups.Results All patients were followed up for 12 months.At 3,6,and 12 months after the surgery,the amplitude of the ulnar nerve conduction velocity and muscle action potential of the perineurium anastomosis group were significantly higher than those in the epineurium anastomosis group(P<0.001).At 12 months after surgery,the excellent-good rate(81.0%)in the perineurium anastomosis group was higher than that in the epineurium anastomosis group(47.4%)(P<0.05).Conclusions Compared with pineurium anastomosis,perineurium anastomosis is a better method in the treatment of wrist ulnar nerve injuries.