单纯尺神经肘部卡压与糖尿病尺神经肘部病变手术操作的差 异简

目的探讨单纯尺神经肘部卡压和糖尿病尺神经肘部病变手术操作的差异。方法回顾性分析43例尺神经肘部卡压病人的临床资料,单纯尺神经肘部卡压（单纯卡压组）31例（单侧病变27例,双侧病变4例）,糖尿病尺神经肘部病变（糖尿病组）12例（单侧病变2例,双侧病变10例）,均行肘部尺神经显微减压术。结果单纯卡压组症状缓解28例,无效3例。缓解率90．3％;糖尿病组症状缓解11例,无效1例,缓解率91．7％。无严重并发症。结论单纯尺神经肘部卡压手术操作重点是解除机械性卡压,将尺神经从周围的瘢痕组织中游离出来。糖尿病尺神经肘部病变手术操作重点是清除肘管内外渗出物．游离肘部尺神经与周围组织间的黏连。

Difference in operation between simple ulnar nerve compression and diabetic ulnar neuropathy at elbow

Objective To explore the difference in operation between simple ulnar nerve entrapment and diabetic ulnar neuropathy at the elbow. Methods Clinical data of 43 patients with ulnar nerve compression were analyzed retrospectively. The patients were divided into 2 groups： simple ulnar nerve compression at the elbow （simple compression group, n = 31, composed of unilateral lesion in 27 and bilateral lesions in 4） and diabetic ulnar neuropathy at elbow （diabetic group, n = 12, including unilateral lesion in 2 and bilateral lesions in 10）. The ulnar nerve microscopic decompression was performed for all these patients. Results The symptom remission occurred in 28 and 11 patients, and inefficacy was seen in 3 and 1 patient, with remission rate of 90.3% and 91.7% for simple compression group and diabetic group retrospectively, without serious complications. Conclusions The focal point for operation is to relieve mechanical entrapment and release the ulnar nerve from surrounding tissues for the simple ulnar nerve compression at the elbow, and to evacuate elbow effusion and dissociate the adhesion between ulnar nerve and its surrounding tissues for diabetic ulnar neuropathy at the elbow.