中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (2): 252-259.doi: 10.4103/1673-5374.152379

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

中国四川汶川地震造成周围神经损伤的恢复:2年随访523例分析

  

  • 收稿日期:2014-10-11 出版日期:2015-02-17 发布日期:2015-02-17

A 2-year follow-up survey of 523 cases with peripheral nerve injuries caused by the earthquake in Wenchuan, China

Chun-qing He, Li-hai Zhang, Xian-fei Liu, Pei-fu Tang   

  1. Department of Orthopedics, Chinese PLA General Hospital, Beijing, China
  • Received:2014-10-11 Online:2015-02-17 Published:2015-02-17
  • Contact: Pei-fu Tang, M.D., zhanglihai@gmail.com.

摘要:

我们对中国四川汶川地震造成523例周围神经损伤的恢复进行了为期2年的随访。首先将神经损伤分为3种:I型为神经切断伤,II型为神经压迫伤,III型为未表现出直接神经功能障碍的损伤。I型损伤31例涉及41条神经,其中22例为开放式横断神经损伤;II型损伤419例涉及823条神经,III型损伤73例涉及150条神经。分析各治疗手段对周围神经损伤恢复的作用发现,手术减压有利损伤神经功能的恢复,物理治疗对I,II型神经损伤有效但对III型神经损伤效果不理想,药物治疗对II,III型神经损伤的影响不大。有针对性的减压手术和物理治疗对神经横断及压迫损伤有效。以路易斯安那州立大学健康科学中心(LSUHSC)得分证实神经损伤程度会随地震解救时间的延长而降低。治疗1年后LSUHSC得分3-5分时的患者得分可上涨28.2-81.8%;但如果此时LSUHSC得分仍为0或1,进一步治疗也将是没有效果的。

关键词: 神经再生, 地震, 周围神经损伤, LSUHSC得分, 筋膜室综合征, 手术治疗, 物理治疗, 神经减压

Abstract:

We performed a 2-year follow-up survey of 523 patients with peripheral nerve injuries caused by the earthquake in Wenchuan, Sichuan Province, China. Nerve injuries were classified into three types: type I injuries were nerve transection injuries, type II injuries were nerve compression injuries, and type III injuries displayed no direct neurological dysfunction due to trauma. In this study, 31 patients had type I injuries involving 41 nerves, 419 had type II injuries involving 823 nerves, and 73 had type III injuries involving 150 nerves. Twenty-two patients had open transection nerve injury. The restoration of peripheral nerve function after different treatments was evaluated. Surgical decompression favorably affected nerve recovery. Physiotherapy was effective for type I and type II nerve injuries, but not substantially for type III nerve injury. Pharmacotherapy had little effect on type II or type III nerve injuries. Targeted decompression surgery and physiotherapy contributed to the effective treatment of nerve transection and compression injuries. The Louisiana State University Health Sciences Center score for nerve injury severity declined with increasing duration of being trapped. In the first year after treatment, the Louisiana State University Health Sciences Center score for grades 3 to 5 nerve injury increased by 28.2% to 81.8%. If scores were still poor (0 or 1) after a 1-year period of treatment, further treatment was not effective.

Key words: nerve regeneration, earthquake, peripheral nerve injury, LSUHSC score, compartment syndrome, surgery therapy, physiotherapy, nerve decompression, neural regeneration