健侧C7神经移位经椎体通路的解剖学研究

发布时间：2018-05-18 13:03

本文选题：臂丛 + 神经移位　；参考：《吉林大学》2008年硕士论文

【摘要】： 随着社会不断的发展和进步,交通事故日益增多。臂丛神经损伤已经成为临床上的常见病、多发病,并且臂丛神经损伤后往往造成上肢的瘫痪及持续的灼性神经痛难以恢复。随着显微外科技术的日臻成熟,使臂丛神经损伤的修复成为可能,当前多采用神经移位的术式治疗臂丛神经根性撕脱伤。包括肋间神经移位、颈丛神经移位、膈神经移位等十余种术式。自1986年顾玉东采用健侧C7移位治疗臂丛神经根性撕脱伤以来,为治疗臂丛神经损伤提供了一个强大的动力神经源,是当前最有效的方法。由于C7神经根较短,无法直接修复对侧臂丛神经,常需要桥接神经,手术次数多,治疗时间长,往往错过了修复神经的最佳时机。王树锋通过解剖及临床研究,通过椎前通路,使C7神经经食管与椎体之间的间隙修复对侧臂丛神经,缩短了手术周期,使受损神经得以早期修复。之后,通过受区神经松解,患侧肩关节内收、前屈位固定,使健侧C7神经与对侧下干之间吻合,取得了良好的效果。为了寻找最直接的解剖通路,使健侧C7能与对侧臂丛神经在无张力的情况下直接吻合,我们设计经椎体通路,并进行了解剖研究。实验证明健侧C7神经经椎体通路可以与对侧上、下干无张力吻合。解剖学意义上讲,健侧C7神经经椎体通路是修复臂丛神经损伤的最佳通路。
[Abstract]:With the continuous development and progress of society, traffic accidents are increasing day by day. Brachial plexus injury has become a common clinical disease, and brachial plexus nerve injury often lead to paralysis of the upper limb and continuous burning neuralgia is difficult to recover. With the development of microsurgical technique, it is possible to repair brachial plexus nerve injury. At present, nerve transposition is often used to treat brachial plexus root avulsion. Including intercostal nerve transposition, cervical plexus nerve transposition, phrenic nerve transposition, etc. Since Gu Yudong treated brachial plexus root avulsion with contralateral C7 transposition in 1986, it has provided a powerful source of dynamic nerve for brachial plexus injury, which is the most effective method at present. Because the C7 nerve root is short, can not directly repair the contralateral brachial plexus nerve, often need to bridge the nerve, many times of operation, treatment time is long, often missed the best time to repair the nerve. Wang Shufeng repaired the contralateral brachial plexus nerve through the space between the esophagus and the vertebral body through anatomic and clinical studies and through the prevertebral pathway. The operation period was shortened and the injured nerve was repaired early. After that, the bilateral C7 nerve was anastomosed with the contralateral inferior trunk by the release of the recipient nerve, the adduction of the affected shoulder joint and the fixation of the anterior flexion position. Good results were obtained. In order to find the most direct anatomic pathway and to make the contralateral C7 anastomosed directly with the contralateral brachial plexus without tension, we designed the vertebral pathway and carried out anatomic study. The results show that the contralateral C 7 nerve can be anastomosed with the contralateral upper and lower trunk without tension. Anatomically speaking, the contralateral C 7 nerve transvertebrae pathway is the best way to repair brachial plexus injury.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2008
【分类号】：R322

【共引文献】