C7神经根移位治疗臂丛损伤术中胸背神经电生理检测的意义

目的探讨术中肌电生理检测对预测C7神经根移位术中胸背神经损伤程度的价值。方法7例全臂丛神经根性撕脱伤患者，均行健侧C7神经根移位术，术中切断C7之前分别刺激健侧臂丛上、中、下干，以及C7神经根各束支，采用肌电仪记录背阔肌动作电位波幅（Amp），了解各神经对背阔肌的支配权重。结果干部刺激后，背阔肌复合肌肉动作电位Amp在上、中、下干分别为（2．26±1．17）mv，（3．47±1．48）mv及（2．67±1．21）my，中干与上、下干之间均存在统计学差异（P〈0．05），而C7各股束支中，后股总体Amp为（4．14±1．94）mv，明显高于前股（2．08±1．24）mv（P〈0．01），且后股内侧Amp最大，为（3．97±1．53）mv，大于后股外侧（2．87±1．41）my（P〈0．05）。背阔肌支配权重在臂丛干部，以中干（41．30％±2．56％）为大，而中干又以中干后股（66．90％±1．72％）、后股内侧（38．37％±1．65％）为大。结论术中电生理检测可以较精确定位背阔肌的支配神经来源，对合理选择C7神经根移位术式、提高C7神经根移位术式安全性具有重要的临床指导意义。

An Intraoperative Electrophyisiology Study of Thoracodorsal Nerve before C_7 Nerve Root Transfer for Brachial Plexus Injury

Objective To discuss the significance of predicting the injury degree of the thoracodorsal nerve by intraoperative electrophysiological examination in the C7 nerve root transfer for brachial plexus injury patients. Methods Each trunk of the brachial plexus followed by each bundles of C7 was stimulated before the contralateral C7 was disconnected. And the ratio of the origination of thoracodorsal nerve controlling the latissimus dorsi muscle was evaluated. Results The highest ratio of the origination of thor...