【摘要】 目的探讨肘上段尺神经桥接健侧C7神经修复正中神经,治疗臂丛神经撕脱伤的可行性。方法尺神经在进入肘管前切断,然后将近端分离至内侧束,将尺神经经胸大肌的深面穿出,经胸前及颈部皮下隧道牵至健侧颈部切口与C7神经根缝合熏二期修复正中神经。术中观察尺神经远端的血供并测量长度。结果本组全臂丛神经撕脱伤13例,中、下干撕脱伤2例,均为男性,年龄14～45岁,平均27岁;受伤时间:1.5～11个月,平均5个月。肘上段尺神经翻转与健侧C7神经根缝合12例;肘上段尺神经及前臂内侧皮神经一起翻转与健侧C7神经根缝合3例。肘上段尺神经的长度21cm～27cm,平均24.7cm,15例尺神经远端血供均良好。尺神经自穿出胸大肌处至健侧C7的距离15cm～22cm,平均17.8cm。结论肘上段尺神经桥接健侧C7神经修复正中神经治疗臂丛神经撕脱伤较传统的手术方法简便、易行。更多还原

【Abstract】 Objective To observe the feasibility of ipsilateral ulnar nerve graft taken from upper arm for bridging the contralateral C7 in treatment of brachial plexus root avulsion injury. Methods The ipsilateral ulnar nerve was cut at the level of elbow and its proximal segment was dissected to the medial cord of the brachial plexus, the ulnar nerve pass through the pectoral major muscle was turned over to the exposed contralateral C7 nerve root through the subcutaneous tunnel of upper chest, the distal end of the proximal part of the ulnar nerve was anastomosed with the C7 nerve root.The length of ulnar nerve was measured and the blood supply of distal end of the ulnar nerve was observed during the operation.The median nerve was repaired at the second stage.Results Thirteen cases with total brachial plexus nerve roots avulsion and 2 case with middle and lower trunk avulsion were performed by this modified procedure, the average age of the patients was 27 years ranging from 14 to 45 years, the duration from injury to operation was from 1.5 to 11 months with a mean of 5 months. The length of ulnar nerve was 22cm～27cm with a mean of 24.7 cm,obvious bleeding with fresh blood from the cut surface of the distal end of the ulnar nerve were observed in 14 cases and drop fresh blood slowly in 1 case. Conclusion The modified procedure of ipsilateral ulnar nerve graft for bridging the contralateral C7 in treatment of brachial plexus root avulsion injury was easier and more convenient than the traditional method.更多还原