非创伤性桡神经麻痹24例临床分析

目的对非创伤性桡神经麻痹的病因，临床表现，治疗结果进行分析。方法自 1985年 1月～ 2000年 1月，共治疗 24例患者，其中男 18例，女 6例；年龄 10～ 65岁，平均 38岁。重体力劳动者及手工劳动者 11例。 1例行肌腱移位术， 23例行桡神经探查，其中 18例行神经松解术， 5例将病变神经段切除（ 2例直接吻合， 3例行游离神经移植）。结果行桡神经探查发现，神经卡压性病变 12例，包括 8例卡压部位位于旋后肌， 1例位于指总伸肌起点腱性部分， 3例多部位多重卡压；神经束带样病变 5例，外在肿物压迫 4例 (2例腱鞘囊肿， 1例脂肪瘤， 1例血管瘤 )，神经肿瘤 1例，不明原因神经病变 1例。 18例神经松解患者术后随访 6个月～ 15年， 14例完全恢复， 1例术后无效， 3例恢复不全； 5例神经吻合或移植患者术后随访 4个月～ 6年， 3例恢复满意， 2例 (1例神经吻合， 1例神经游离移植 )由于术后时间短，仍在恢复中。结论非创伤性桡神经麻痹病因较多，手术治疗效果良好。

Non-traumatic paralysis of radial nerve: a report of 24 cases

Objective Twenty- four case of non- traumatic paralysis of radial nerve were reviewed. Methods Between 1985 and 2000, 24 patients with non- traumatic paralysis of radial nerve were referred to this hospital for treatment. There were 18 men and 6 women with a mean age of 38 years (range, 10 to 65 years). Eleven patients had occupations with unduly stress of the forearm. Tendon transfer was performed in 1 patient, operative neurolysis in 18, nerve- grafting in 3, neurorrhaphy in 2. Results Of the 12 patients with the palsy attributed to entrapment of the fibrous edge of muscles, 8 occurred at the supinator, 1 at the tendinous edge of extensor digitorum communis and 3 at multiple sites.The palsy was caused by marked constrictions of the nerves in 5 patients, by benign tumors or tumorous conditions in 4 (by a ganglion in 2, by lipoma in 1 and by haemangioma in 1), by a neurilemmoma on the nerve in 1. The cause was unknown in 1. The patients who accepted neurolysis were followed up from 6 months to 15 years postoperatively. An excellent or good functional result was documented in 14 patients, fair in 3, and poor in 1. The patients who were treated with neurorrhaphy or nerve- grafting were followed- up from 4 months to 6 years, 3 recovered completely, 2 were in the convalescent stage (1 was treated by nerve- grafting and the other by neurorrhaphy). Conclusion The etiology of non- traumatic paralysis of radial nerve was miscellaneous. The results of surgical treatment were satisfactory.