神经松解术治疗上肢原因不明的神经炎

目的 为探索原因不明神经炎的诊断与治疗方法，以提高对此类疾患的认识和治疗水平。方法 对8例原因不明的上肢神经炎进行临床分析，其中尺神经6例，桡神经2例，病最短5个月，最长达4年，将切除的神经外膜送病理检查，均为非特异性炎性改变。治疗采取神经外膜或束膜切开松解手术加局部注射醋酸强的松龙。结果 尺神经6例中5例术前疼痛消失、感觉和运动功能障碍（包括手内在肌萎缩）已完全恢复、1例感觉功能完全恢复，运动功能及手内肌萎缩部分恢复，术后1年另侧肢体出现同样体征，治疗后的效果待进一步随访。桡神经2例，1例完全恢复，另1例剧痛完全缓解。结论 原因不明的周围神经炎的诊断有待进一步探讨，神经松解手术加注射皮质激素的治疗效果较非手术疗法的效果要好，值得推荐。

Treatment for upper limb neuritis of unknown cause by neurolysis

Objective In order to make a definite diagnosis and raise the therapeutic level for the upper limb neuritis of unknown cause Methods A study on upper limb neuritis of unknown cause was carried out on eight patientsThere were six men and two women,with a mean ages of 34 yearsFindings were initially restricted to the ulnar nerve distrbution in six patients,and radial nerve in two patientsClinical course was from five months to four yearsAll the patients were subjected to neurolysis or interfascicular neurolysis combined with perineural prednisolone acetate injection at the same timeMicroscopically,it appears the nonspecific in resecting epineurium Results Neuritic pain was first to disappearSix patients showed sensory and motor function recovery,except one patient appears the same symptoms as involving ulnar nerve at the other limb one year laterThe another patient involved radial nerve only relieved severe pain Conclusions The diagnosis of limbs neuritis without any known cause is going to make a thorough inquiryNeurolysis is a satisfactory method,the result is distinctly better than nonsurgical treatments