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尺神经神经束膜瘤二例
引用本文:彭峰,王涛,陈琳.尺神经神经束膜瘤二例[J].中华手外科杂志,2009,25(5).
作者姓名:彭峰  王涛  陈琳
作者单位:复旦大学附属华山医院手外科,上海,200040
基金项目:卫生部临床学科重点项目基金资助,上海市周围神经显微外科重点实验室课题基金资助项目 
摘    要:目的 总结2例尺神经神经束膜瘤患者的诊治过程,并对该病进行相关的文献复习.方法 例1为女性患者,发现右上臂肿块3年,术前患肢感觉正常,手部运动功能略减退.术中见肘上尺神经呈梭形增粗膨大约4cm×2cm,将肿瘤切除1周后行腓肠神经移植修复.例2为男性患者,发现右肘部肿块3个月,术前右小指刺痛觉减退,手内在肌肌力下降.术中见尺神经于肘部呈梭形增粗膨大约9 cm×4 cm,切取部分尺神经组织送病理检查.结果 术后2例病理报告均为尺神经神经束膜瘤.例1术后随访3个月,未见肿瘤复发,尺神经支配区手功能无恢复.例2术后随访9个月,肿瘤无增大,手功能与术前相同.结论 神经内神经束膜瘤是一种少见的良性病变过程,对于病理诊断明确的患者,可手术切除并行神经修复,也可取神经活组织检查,定期随访肿瘤的进展情况.

关 键 词:尺神经  病理学  治疗  神经束膜瘤

Two cases report of intraneural perineuriolma of the ulnar nerve
Abstract:Objective To summariariae the diagnosis and treatmentof 2 cases of intraneuml perineurioma involving the ulnar nerve and review the relevant fiterature. Methods Case one was a female patient who had a mass of her right.upper arm for 3 years.Preoperatively the sensadon was normal.however the hand movement was impaired.Intraoperatively a 4 cm×2 cm fusiform enlargement of the ulnar nerve above elbow was seen.The mass was reseeted and sural nerve graft was done one week later to repair the nerve.Case two was B male patient who had a mass around his right ellbow for 3 months.Preoperatively there was diminished sensatiln of the right little finger and decreased strength of the hand intrinsic muscles.Intraoperadvely a 9 cm×4 cm fusiform enlargement of the ulnar nerve at the elbow was seen.A neve biopsy was carried out for pathology.Results Pathology for both cases was intraneural perineurioma of the ulnar nerve.Case one was followed for 3 months with no sign of tumor recurrence Hand functions innervated by the ulnar nerve were unchanged .Case two was followed for 9 months and the mass didn't become bigger.Hard function was the same comparing to the preoperative level.Conclusion Intraneural perineurioma is a rare benign tumor.Surgical resection and nerve repair is the treatment option for those with pathologically confirmed cases.Nerve biopsy and regular follow up is 5nother option.
Keywords:Ulnar nerve  Pathology  Therapy  Perineurioma
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