分娩性臂丛神经损伤的手术治疗

为了探讨治疗分娩性臂丛神经损伤各种术式的疗效，对１９８４～１９９４年手术治疗的１６例进行回顾和随访。手术年龄３个月～１１岁，其中１岁以下４例。损伤部位：上干型１０例，下于型４例，全臂型２例。手术方式：神经松解术７例，神经移位或移植术３例，上肢功能重建术６例。１５例得到２～１２年随访（平均１０．５年），有效率７３％（１１／１５），优良率４７％（７／１５），１岁以下随访３例均属优良。结论：如果伤后３～６个月经综合治疗无明显功能改善者，应积极手术探查。手术应借助显微外科器械完成，松解应彻底。

Surgical Treatment for Birth Injuries of Brachial Plexus

Sixteen children ( 3 mons to 11 yrs ) with birth injuries of the brachial plexus underwent surgical creatment from 1984 to 1994. Ten were injuries of upper trunk , 4 of lower trunk . and 2 of the whole brachial plexus. The operations included : neurolysis in 7 , nerve trans- position or transplantation. in 3 , and reconstruction of the functions of upper. extremity in 6 Fifteen cases were followed up for 2 to 12 years with a mean of 10. 5 years. The successful results were ll/15 (73% ) and three under one year of age recovered perfectly. Conclusion , Operative exploration should be performed on those cases unresponsive to therapy after 3 to 6 mons Neurolysis should be done thoroughly with microsurgical techniques.