正中神经尺神经部分束支移位术后供体神经功能变化的研究

目的 观察正中神经、尺神经部分束支移位术后供体神经功能的变化，评价此手术方法的可行性及安全性。方法 对施行正中神经、尺神经部分束支移位术的82例患者（移位神经88例次）进行观察。观察内容包括：①感觉：神经单一分布区的两点辨别觉以及主观感觉；②运动：肌力、握力、捏力；③自主神经功能：排汗功能（溴酚蓝实验）。结果 大多数患者手术后肢体功能没有明显变化。部分患者术后感到手术的影响，主要表现有手指麻木感，两点辨别觉稍有差别；肌力有变化，握力及捏力测定稍有差别。但是，这些变化一般比较轻微，对肢体功能无明显影响，并且在术后12个月后逐渐减轻、消失。所有患者手部排汗功能无变化，未出现营养不良改变或原有变化加重。结论 正中神经、尺神经部分束支移位术对供体神经功能无明显影响，手术是安全的。

Functional changes after Median nerve or Ulnar nerve fascicle transfer

Objective The functional changes of the donor nerve were observed after the median nerve or ulnar nerve fascicle transfer.The feasibility and safety of the operation were evaluated.Methods 82 cases of upper type of the brachial plexus injury were treated by median nerve(58 cases) or ulnar nerve(30 cases) fascicle transfer.Special attentions were paid to the functional changes of the donor nerve to make sure the safety of the operation.Two point discriminations of the dominate site were measured to evaluate the sense functional changes.The strength of the muscle,grasp and pinch were used to evaluate the motor functional changes.Perspiration were observed to evaluate the function of the autonomic nerve.Results We observed that only minority had showed slight weakness,trifling and uniform depression of cutaneous sensibility.Furthermore,the weakness and depression would disappear in about 2 months.Conclusions We concluded that fascicle of median nerve and ulnar nerve can be transferred without effects on the donor nerve.