医源性桡神经损伤的原因及防治对策

目的：分析医源性桡神经损伤的原因并探讨其防治措施。方法：对1998～2003年收治的41例医源性桡神经损伤患者采用非手术治疗21例，行神经内外松解术者12例，直接缝合者8例，手术无效的4例行肌腱移位术。结果：经6个月～5年的随访，非手术治疗组痊愈20例，好转1例。神经内外松解者中，痊愈8例，好转2例，无效2例。直接缝合组痊愈6例，无效2例。结论：医源性桡神经损伤的主要原因为：局部解剖不熟悉，技术操作不规范。杜绝上述原因，桡神经损伤是可以避免的；桡神经损伤后如果及时采取相应的治疗措施，其预后多良好。

Analysis of the reason and prevention of the iatrogenic injury of radial nerve

Objective: To investigate the cause and prevention of the iatrogenic radial nerve injury. Methods: From 1998 to 2003, 41 patients with iatrogenic radial nerve injury were treated with non operative treatment in 21 cases, neurolysis in 12 cases, direct suture in 8 cases and plus tendon transposition in 4 cases. Results: 20 cases full recovered at the non operative treatment group, one case improved. 8 cases full recovered at the neurolysis group, 2 cases improved, 2 cases were inefficiency. 6 cases full recovered at the direct suture group, 2 cases were inefficiency. Conclusion: The main causes of the iatrogenic radial nerve injury are unfamiliar to the local anatomy, crude operation technique and lack of responsibility. As long as the above mentioned reasons to be iliminated, the radial nerve injury can be avoided. If corresponding therapeutic steps are taken after injury, the prognosis will be satisfactory.