胡溱 董虎林 韦加宁 胡琪 张云涛 胡溱(100035 北京积水潭医院手外科)；韦加宁(100035 北京积水潭医院手外科)； 胡琪(100035 北京积水潭医院手外科)；张云涛(100035 北京积水潭医院手外科)；董虎林(山西省阳泉市第三人民医院) 中华手外科杂志 2000 0 16 1


    关键词：神经移植；肌皮神经；肋间神经；臂丛 期刊 zhswkzz 0 论著 fur -->


    

摘 要：目的 比较肋间神经移位直接与肌皮神经缝合,和通过皮神经移植桥接肌皮、肋间神经两种术式的疗效。方法 32例全臂丛根性撕脱伤,其中将肋间神经游离10～13cm,经电刺激证实含有运动神经束后切断,与肌皮神经直接缝合20例。在肋间神经与肌皮神经间移植皮神经(平均长10.2cm)12例。术后平均随访3年,观察肱二头肌屈肘功能及肌力的恢复。结果 肌力达3级或3级以上的,神经移位组占75%,神经移植组为25 %。结论 肋间神经与肌皮神经缝接后,屈肘功能恢复明显,直接缝合组优于神经移植桥接组(P<0.01)。

Comparison of twoprocedures of intercostal nerve transfer for treatment of total brachial plexus rootavulsion

HU Zhen DONG Hulin WEI Jianing， et al.

    ( Department of HandSurgery, Beijing Jishuitan Hospital, Beijing 100035,China)

Abstract： Objective To compare the treatment outcome of intercostal nervetransfer to the musculocutaneous nerve by direct suture or via cutaneous nerve grafting.Methods Intercostal nervetransfer to the musculocutaneous nerve was done in 32 cases.In 20 cases, the intercostalnerve was mobilized for 10 - 13 cm.After being proved by electrical stimulation that itcontains motor fibers,the intercostal nerve was transected and directly sutured with themusculocutaneous nerve.In the other 12 cases, intercostal nerve transfer to themusculocutaneous nerve via nerve graft (on average 10.2 cm in length) was done.Thepatients were followed for an average of 3 years to evaluate the muscle power of bicepsbrachii and recovery of elbow flexion.Results The rate of restoration of muscle power to MRC III or overMRC III was 75 % for direct suture group and 25 % for nerve graft group.Conclusions There was obvious recovery ofelbow flexion after intercostal nerve transfer to musculocutaneous nerve.The result ofdirect suture was superior to that of nerve grafting.

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