带血管蒂尺神经肌筋膜下前置术治疗中度肘管综合征

发布时间：2018-05-24 06:05

本文选题：肘管综合征 + 尺神经　；参考：《中国矫形外科杂志》2017年05期

【摘要】：[目的]评价带血管蒂尺神经肌筋膜下前置术治疗中度肘管综合征的疗效。[方法]通过对6例防腐成人上肢标本观察测量肘部尺神经血供来源和血管外径及血管长度的相关数据,对30例中度肘管综合征患者,分为两组,分别采用带血管蒂尺神经肌筋膜下前置术和单纯肌筋膜下前置术,参照中华医学会手外科学会制定的尺神经修复后功能评定试用标准,Lascar分级法和术前术后尺神经神经电生理变化,对疗效进行评价比较。[结果]尺神经的营养伴行血管有3条。伴神经走行的长度分别为尺侧上副动脉(144.0±3.3)mm、尺侧下副动脉(47.6±7.2)mm、尺侧返动脉后支(66.2±8.3)mm。带血管尺神经筋膜下前置术优良率为93.3%,单纯肌筋膜下前置术优良率为80%,两组比较差异有统计学意义。神经电生理检查:带血管尺神经肌筋膜下前置术优于单纯肌筋膜下前置术,两组比较差异有统计学意义。[结论]带血管蒂尺神经肌筋膜下前置术疗效可靠,方法简便,是治疗中度肘管综合征的有效方法。
[Abstract]:Objective: to evaluate the efficacy of vascularized ulnar nerve myofascial preimplantation in the treatment of moderate cubital tunnel syndrome. [methods] 30 patients with moderate cubital tunnel syndrome were divided into two groups by observing and measuring the blood supply source, vascular diameter and vascular length of ulnar nerve in 6 antiseptic adult upper limb specimens. The ulnar nerve with vascular pedicle was performed with subfascial preposition and simple subfascial preposition. According to the standard for functional evaluation of ulnar nerve repair developed by the Chinese Medical Association of hand surgery and the electrophysiological changes of ulnar nerve before and after operation, the curative effect was evaluated and compared. [results] there were 3 vessels associated with ulnar nerve nutrition. The length of the accompanying nerve was 144.0 卤3.3 mm in the superior ulnar collateral artery, 47.6 卤7.2 mm in the inferior ulnar collateral artery and 66.2 卤8.3 mm in the posterior branch of the recurrent ulnar artery. The excellent and good rate of subfascial anterior operation with vascular ulnar nerve was 93.3 and that of simple subfascial anterior operation was 80. The difference between the two groups was statistically significant. Nerve electrophysiological examination: the ulnar nerve with blood vessels was superior to the simple subfascial anterior operation, the difference between the two groups was statistically significant. [conclusion] the subfascial preoperation of ulnar nerve pedicled with blood vessel is effective and simple, and it is an effective method for the treatment of moderate cubital tunnel syndrome.
【作者单位】：山东省潍坊市人民医院骨科;
【分类号】：R688

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