神经松解减压治疗前臂缺血性肌挛缩49例临床分析
前臂缺血;,肌挛缩;,神经;,早期松解,,前臂缺血;,肌挛缩;,神经;,早期松解,关键词：前臂缺血;肌挛缩;神经;早期松解,1资料与方法,2结果,3讨论,参考文献:
摘要: 目的：探讨前臂缺血性肌挛缩行早、晚期神经松解减压手术的临床疗效。方法：选择1999年1月～2005年10月收治的49例行神经松解减压术的前臂缺血性肌挛缩患者，按手术时间分为早期手术组(3个月内)和晚期手术组(3个月以上)，根据手功能评价标准比较2组患者术后手内在肌挛缩程度和手部感觉功能恢复情况。结果：获随访33例，随访时间6个月～5年。早期手术组14例中优7例，良5例，可1例，差1例，优良率为85.71%；晚期手术组19例中优5例，良4例，可1例，差9例，优良率为47.37%。早期手术组优良率明显高于晚期手术组(P<0.05)。结论：神经松解减压术宜早期施行。早期手术能够有效解除组织缺血，防止挛缩纤维化，减轻神经压迫和损害，有利于手功能的恢复。关键词： 前臂缺血; 肌挛缩; 神经; 早期松解
Clinical outcome of 49 cases nerve decompression and reduction for Volkmann′s contracture of the Forearm
Kahar·Aikenmu, Aihemaiti·Yusufu, Alimujan·Ablati, et al
(Department of Spine Surgery, Affiliated Traditional Chinase Medicine Hospital,Xinjiang Medical University, Urumqi 830054, China)
Abstract: Objective: To observe the clinical outcome of early and late surgical treatment for Volkmann′s contracture, and discuss timing of the operative management. Method: 49 cases of nerve decompression and reduction for forearm Volkmann′s contracture from Jan 1999 to oct 2005 were divided into early surgery group (within 3 months) and late surgery group (over 3 months )after the injury ,compare the restoration of hand sense function between the two groups after operation. Results: Thirtythree cases were reviewed. The followingup varied from 6 month to 5 years. Early operation (within 3 months) fore 14 cases were followed up. The result of 7 excellent, 5 good, and 1 fair, 1 bad. The percentage of being excellent and good was 85.71%, late operation for 19 cases were followedup. The result of 5 excellent, 4 good, and 1 fair, 9 bad. The percentage of being excellent and good was 47.37%. The early surgery group′s good and excellent percentage obliviously higher than that in late surgery group. Conclusions: The shorter the interval from injuries to the operation was, the less severe hand muscle contracture was, and the more satisfactory the restoration of hand sense function was. The operation of decompression and release of the nerves should be performed earlier. The best timing for operation is within 3 months after injuries. ......
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