双侧痛性指固有神经瘤手术新方法——神经弓式双端侧吻合 |
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引用本文: | 江起庭,;杨丽娜,;高志强,;吴李峰,;王钰,;江志伟.双侧痛性指固有神经瘤手术新方法——神经弓式双端侧吻合[J].中国中西医结合外科杂志,2014(4):382-385. |
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作者姓名: | 江起庭 ;杨丽娜 ;高志强 ;吴李峰 ;王钰 ;江志伟 |
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作者单位: | [1]南京高新医院手外科中心,南京210000; [2]巢湖紫晨手外科医院手外科中心,巢湖238000; [3]沈阳医学院附属中心医院沈阳市手外科研究所,沈阳110024; [4]南京军区南京总医院全军普外科研究所,南京210002 |
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基金项目: | 江苏省科技计划重点资助项目(BS2007054); 南京军区科技创新重点资助项目(07Z028) |
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摘 要: | 目的:探讨一种治疗双侧痛性指固有神经瘤的手术新方法。方法:双侧痛性指固有神经瘤30例患者,11例采用神经移植神经弓式的双端侧吻合,10例采用神经移植端-端吻合,9例采用直接端-端吻合。结果:术后随访24.5~52个月,平均38个月。双端侧吻合组指感觉测定为S(4.35±1.98)级,高于另2组(P=0.027);两点分辨觉为(5.0±0.7)mm,小于另2组(P=0.022);3组Burchiel疗效差异有统计学意义(Z=-1.733,P=0.020)。结论:神经移植双端侧神经吻合的方法可有效治疗双侧痛性指固有神经瘤,消除患指疼痛、恢复指腹触摸灵敏性。
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关 键 词: | 神经瘤 疼痛 顽固性 修复外科手术 |
A New Method of Arched Nerves of Double end-to-side Neuroanastomosis for Repairing Refractory Pain Caused by Double Digital Neuroma |
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Affiliation: | JIANG Qi-ting, GAO Zhi-qiang, WU Li-feng, et al. (Department of Hand Surgery, Nanfing High-tech Hospital, Nanjing (210000), China.) |
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Abstract: | Objective To introduce a new method in treating refractory pain caused by double digital neuroma. Methods Thirty patients with bilateral acute proper digital nerve injuries were admitted. Eleven patients underwent double end-to-side neuroanastomosis, 10 patients underwent nerve graft with end-to-end neuroanastomosis, while other 9 patients underwent directly end-to-end neuroanastomosis. Results All 30 patients were successfully followed up for 24.5 to 52 months, with an average of 38.2 months. In double end-to-side neuroanastomosis group, the average result of sensation measurement was S(4.35±1.98) which was significantly higher than those of the other 2 groups(P=0.027); the average result of two point discrimination was (5.0 ± 0.7) mm which was significantly lower than those of the other 2 groups(P=0.022). According to Burchiels evaluation criteria, there were differences in results of pain relief in the 3 groups(Z=-1.733P=0.020). Conclusion Refractory pain caused by double digital neuroma can be effectively treated by double end-to-side neuroanastomosis, which can eliminate painness and restore sensation of wounded fingers. |
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Keywords: | Neuroma pain intractable reconstructive surgical procedures |
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