放射性臂丛神经损伤20例的临床分析

Clinical analysis of the treatment of radiation injury of brachial plexus

目的:探讨放射性臂丛神经损伤的诊断和治疗。方法:2008年8月-2010年8月收治放射性臂丛神经损伤患者20例,随机分为两组,各10例。第1组使用神经松解治疗,为A组;第2组使用神经松解加肌皮瓣覆盖治疗,为B组。结果:两组进行2年随访,发现A组在术后仍需其他药物来缓解疼痛,轻度疼痛8例,疼痛消失0例,无明显疼痛改善,运动功能无改善;B组在术后无需或者少需其他药物来缓解疼痛,轻度疼痛3例,疼痛消失7例,疼痛有明显改善,运动功能无改善。两组在治疗疼痛方面相比较,B组明显好于A组(P<0.05);而对于运动功能两组都无明显改善(P>0.05)。结论:此病治疗时主要以帮患者缓解疼痛为主,可见使用神经松解加肌皮瓣覆盖的方法可极大地减轻患者的痛苦,是缓解并发症疼痛的主要手段。

Objective:To investigate the diagnosis and treatment of radiation injury of brachial plexus.Methods:20 cases with radiation-induced brachial plexus injury were selected from August 2008 to August 2010.They were randomly divided into two groups with 10 cases in each.The first group used neurolysis for treatment as A group;the second group used neurolysis and muscle flap coverage for treatment as B group.Results:Two groups were followed up for 2 years.It was found that A group after still need other drugs to relieve pain;8 cases were mild pain;pain was disappeared in 0 case;there was no significant improvement in pain;motor function was unchanged.After operation,B group was without or with less other drugs to ease the pain;3 cases were mild pain;pain was disappeared in 7 cases;pain was obviously improved;motor function was unchanged.Comparison in the treatment of pain,the B group was significantly better than the A group(P<0.05).While for motor function,there was no significant improvement in two groups(P>0.05).Conclusion:The treatment is mainly to help the patients to relieve pain.The use of neurolysis and muscle flap coverage can greatly alleviate the suffering of patients.It is the main means to alleviate the pain of the complications.