坐骨神经损伤的手术治疗

目的 总结坐骨神经损伤手术治疗的方法和疗效。方法 自1990年1月至2000年7月对28例坐骨神经损伤的患者进行手术治疗，手术方法包括单纯松解术、神经松解＋部分吻合术、重新吻合术和神经移植术。根据Sunderland坐骨神经功能恢复标准判断疗效。结果 本组22例获随访，随访时间13个月－5年，平均2年6个月。按上述标准评定优7例，良5例，可7例，差3例，优良率为54.5%。结论 坐骨神经损伤手术后疗效欠佳与其解剖特点有关，如果坐骨神经损伤或初次手术后3个月以上神经功能仍毫无恢复，Tinel征及肌电图检索提示神经无向远端再生的迹象，应积极地手术探查，术中电生理监测对决定手术方式及预计术后神经功能的恢复情况有较大的帮助。

Repair of sciatic nerve injury

Objective To summarize repair methods and results of sciatic nerve injury. Methods Repair of sciatic nerve injury was carried out in 28 patients between January 1990 and July 2000.The methods of nerve repair included neurolysis, neurolysis plus partial nerve repair, nerve repair and nerve graft. The outcome was evaluated according to Sunderland criteria. Results Twenty two patients were followed up with a follow up period from 13 months to 5 years (average of 2 year 6 months). Of 22 nerves, 7 were excellent, 5 good, 7 fair and 3 poor. Conclusions The fair results of sciatic nerve injury are due to its anatomical characteristic. Surgical procedure should be performed if nerve function does not recover after 3 months or Tinel's sign and electromyogram show no signs of nerve regeneration. Electrophysiological monitoring in the operation is useful in selecting operation methods and predicting the results of nerve repair.