放射性臂丛神经损伤的临床治疗分析

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临床治疗方法。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。A组使用神经松解治疗;B组使用神经松解加肌皮瓣覆盖治疗。结果:对两组治疗患者进行2年的随访,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,使用神经松解加肌皮瓣覆盖的方法可极大的减轻患者的痛苦,是缓解该并发症疼痛的主要手段,值得临床应用。

Objective:To explore the clinical treatment of radiation injury of brachial plexus.Methods:20 patients with radiation injury of brachial plexus were selected from August 2008 to August 2010.They were randomly divided into two groups with 10 cases in each.Group A were treated with nerve loose solution treatment;group B were treated with neurolysis and muscle flap coverage for treatment.Results:Two groups of patients were followed up for 2 years.After operation, group A still needed other drugs to relieve pain;8 cases were mild pain;pain was disappeared in 0 cases;there was no significant improvement in pain;motor function was unchanged.After operation, group B did not need or need less other drugs to relieve pain;3 cases were mild pain;pain was disappeared in 7 cases;pain could obviously improved;motor function did not improve.We compared the treatment of pain of the two groups, and group B was obviously better than group A(P<0.05);the motor function of the two groups were no significant improvement(P>0.05).Conclusion:In the treatment of the disease,the main purpose is to relieve the pain of the patients.The use of neurolysis and muscle flap coverage can greatly alleviate the suffering of patients,and it is the main means to alleviate the pain of the complications.It is worthy of clinical application.