神经端侧吻合的临床应用及效果探讨

Clinical application of nerves end-to-side neurorrhaphy

目的 探讨神经端侧吻合的临床疗效。方法 自 1998年起应用神经端侧吻合治疗 11例新鲜与陈旧性桡神经、尺神经、腓总神经损伤 ,采用远端神经与邻近神经干外膜“开窗”做端侧呈 3 0～ 5 0°夹角的吻合方法。结果 本组 11例经 11～ 2 5个月随访 ,按MCRR的神经疗效评定标准M4 S3+以上为优 ;M3S3为良 ;M2 S2 为中 ;M1 S1 以下为差。本组M4 为 0例 ,M3为 3例 ,M2 为 5例 ,M1 为 2例 ,M0 为 1例 ,运动神经良好率为 2 7%。S3+为 2例 ,S3为 5例 ,S2 为 3例 ,S1 为 1例。优良率为 63 .6%。结论 神经端侧吻合感觉的恢复较为理想而对运动的恢复效果欠佳 ,应慎重评价端侧吻合法。

Objective To try to find out the clinical application after nerves end to side neurorrhaphy.Methods Since 1998,we used the way of nerves end to side to assume 30～50°angle neurorrhaphy to treat 11 cases of fresh and old injury of nerve,it include 7 cases of ulnar nerve ,2 cases of radial nerve injury,2 cases of common peroneal nerve injury.Results Eleven cases were followed up.The time of follow up was 11～25 months.According to the standard of MCRR:M 3S 3 + hereinbefore is excellent,M 3S 3 is good,M 2S 2 is acceptable,M 1S 1 hereinafter is inefficient.The result:M 4 is 0 cases,M 3 is 3 cases,M 2 is 5 cases,M 0 is one cases.The rate of excellent and good of motor nerve was 27%.M 3S 3 + is 2 cases,S 3 + is 2 cases,S 3 is 5 cases,S 2 is 3 cases,S 1 is one case.The rate of excellent and good of sensory nerve was 63.6%.Conclusion Nerves end to side neurorrhaphy is very good for sensory nerve but isn't satisfactiory for motor nerve.So we should estimate the way of nerves end to side neurorrhaphy carefully.