臂丛神经损伤早期修复的临床研究

目的研究臂丛神经损伤早期行神经修复的可行性和优点。方法2004年2月-2005年10月，对5例早期臂丛神经损伤患者行神经探查修复术。其中2例为臂丛神经束支部损伤，3例为臂丛神经根性撕脱伤。受伤后至手术时间最短为4h，最长为25d，平均为5．8d（140h）。4例伴有锁骨下动脉或腋动脉损伤，2例伴有锁骨骨折，均在修复神经的同时行血管和骨折的处理。结果5例患者在术中及术后均未出现严重的并发症。术后随访时间为12—24个月。臂丛神经功能均有不同程度的恢复，血管通畅性良好。结论臂丛神经损伤早期行探查修复手术有利于神经的再生，但需严格掌握手术适应证，并需具备相应的医疗能力。

Clinical study on early operation of brachial plexus injuries

Objective To investigate the possibility and advantages of early operation on patients with brachial plexus injuries. Methods From February 2004 to October 2005 early surgical exploration and repair of the brachial plexus was done in 5 patients with brachial plexus injuries. Two cases were diagnosed as injuries at the cord level while 3 cases were root avulsions. The average interval from injury to operation was 5.8 days, ranging from 4 hours to 25 days. Concomitant injury of the subclavian artery or axillary artery was seen in 4 cases. Two cases also had fracture of the clavicle. In those cases arterial repair and fracture fixation were carried out at the same time of nerve reconstruction. Results There were no severe complications either intraoperatively or postoperatively. The patients were followed for 12 to 24 months. The repaired vessels were patent. Function of the reconstructed nerves was restored to certain extent. Conclusion Early operation of braehial plexus injury makes it possible to repair complex injuries at the same time and is favorable for nerve regeneration. This however should only be considered in selective cases and when circumstances allow.