中国神经再生研究(英文版) ›› 2014, Vol. 9 ›› Issue (6): 582-588.doi: 10.4103/1673-5374.130095

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

超声对地震周围神经损伤修复的及时及后续评价

  

  • 收稿日期:2014-02-26 出版日期:2014-03-22 发布日期:2014-03-22
  • 基金资助:

    国家高技术研究发展计划(863计划)(2008AA022400),四川省科技厅项目(2009Y0174),成都市科技局项目((2012) 530021)

Follow-up evaluation with ultrasonography of peripheral nerve injuries after an earthquake

Man Lu 1, Yue Wang 2, Linxian Yue 1, Jack Chiu 3, Fanding He 1, Xiaojing Wu 2, Bin Zang 2, Bin Lu 2, Xiaoke Yao 2, Zirui Jiang 4   

  1. 1 Department of Ultrasound, Sichuan Provincial People’s Hospital, Chengdu, Sichuan Province, China
    2 Department of Orthopedics, Sichuan Provincial People’s Hospital, Chengdu, Sichuan Province, China
    3 Department of Radiology, University Hospital, University of Western Ontario, Ontario, Canada
    4 Chengdu Jiaxiang Foreign Languages School, Chengdu, Sichuan Province, China
  • Received:2014-02-26 Online:2014-03-22 Published:2014-03-22
  • Contact: Yue Wang, M.D., Ph.D., Department of Orthopedics, Sichuan Provincial People’s Hospital, Chengdu 610072, Sichuan Province, China, wangyue@medmail.com.cn.
  • Supported by:

    This study was supported by a grant from the National High Technology Research and Development Program of China (863 Program), No. 2008AA022400; a grant from the Sichuan Technology Department of Sichuan Province, No. 2009Y0174; a grant from the Chengdu Technology Department of Chengdu City, No. (2012) 530021.

摘要:

与地震相关的以超声评价周围神经损伤的研究非常有限,但超声诊断周围神经损伤的价值已得到临床的肯定。为验证超声评价对地震伤者周围神经损伤修复的效果,实验经临床查体及超声筛选出来的中国2008年汶川大地震所致周围神经损伤患者34例,超声发现59条神经损伤,48条神经由于瘢痕或肌腱等卡压所致,11条神经完全断裂。手术中发现34例患者59处损伤中仅有1例(1处)出现超声误诊。手术前超声结果与手术探查的符合率为98%。手术后随访48条卡压神经经松解后基本恢复正常,仅5条神经周围还可见瘢痕组织。手术前后临床和超声的结果之间有较高的一致性,验证了超声评价不仅可以对周围神经损伤做手术前诊断,还可以做效果的后续评价。

关键词: 神经再生, 地震, 汶川, 超声, 周围神经, 神经损伤, 修复, 随访

Abstract:

Published data on earthquake-associated peripheral nerve injury is very limited. Ultrasonography has been proven to be efficient in the clinic to diagnose peripheral nerve injury. The aim of this study was to assess the role of ultrasound in the evaluation of persistent peripheral nerve injuries 1 year after the Wenchuan earthquake. Thirty-four patients with persistent clinical symptoms and neurologic signs of impaired nerve function were evaluated with sonography prior to surgical repair. Among 34 patients, ultrasonography showed that 48 peripheral nerves were entrapped, and 11 peripheral nerves were disrupted. There was one case of misdiagnosis on ultrasonography. The concordance rate of ultrasonographic findings with those of surgical findings was 98%. A total of 48 involved nerves underwent neurolysis and the symptoms resolved. Only five nerves had scar tissue entrapment. Preoperative and postoperative clinical and ultrasonographic results were concordant, which verified that ultrasonography is useful for preoperative diagnosis and postoperative evaluation of injured peripheral nerves.

Key words: nerve regeneration, earthquake, Wenchuan, ultrasound, peripheral nerve, nerve injury, repair, follow-up, 863 Program, neural regeneration