中国神经再生研究(英文版) ›› 2016, Vol. 11 ›› Issue (2): 338-344.doi: 10.4103/1673-5374.169638

• 原著:神经损伤修复保护与再生 • 上一篇    下一篇

实施指神经缺损修复后早期制动与感觉再教育有必要吗?

  

  • 收稿日期:2015-12-02 出版日期:2016-02-15 发布日期:2016-02-15

Influence of immobilization and sensory re-education on the sensory recovery after reconstruction of digital nerves with direct suture or muscle-in-vein conduits

Theodora Manoli, Jennifer Lynn Schiefer, Lukas Schulz, Thomas Fuchsberger, Hans-Eberhard Schaller   

  1. Department of Hand, Plastic and Reconstructive Surgery, Burn Unit, BG Trauma Center, University of Tuebingen, Tuebingen, Germany
  • Received:2015-12-02 Online:2016-02-15 Published:2016-02-15
  • Contact: Theodora Manoli, M.D.,theodora.manoli@gmail.com.

摘要:

为研究制动与感觉再教育对直接缝合或肌肉静脉导管修复指神经缺损术后效果的影响,我们对35例(41指神经损伤)患者以直接缝合或肌肉静脉导管修复重建,并于术后12个月应用静止和移动两点辨别觉及Semmes-Weinstein单丝检测感觉功能恢复情况。结果显示,术后制动3-7d与10d对接受直接缝合或肌肉静脉导管修复患者的感觉功能恢复影响无明显差异,接受与未接受感觉再教育患者在两种术式修复神经缺损后的神经功能恢复也无明显差异。可见早期制动并不会对指神经修复后的功能重建有消极影响,同时是否要对指神经手术后的患者进行感觉再教育也需谨慎考虑。

关键词: 神经再生, 周围神经, 指神经, 感觉再教育, 制动, 手指, 直接缝合, 肌肉静脉导管

Abstract:

The influence of duration of immobilization and postoperative sensory re-education on the final outcome after reconstruction of digital nerves with direct suture or muscle-in-vein conduits was investigated. The final sensory outcome of 35 patients with 41 digital nerve injuries, who either underwent a direct suture (DS) or a nerve reconstruction with muscle-in-vein conduits (MVC), was assessed the earliest 12 months postoperatively using static and moving two-point discrimination as well as Semmes-Weinstein monofilaments.
There was no significant difference in sensory recovery in cases with an immobilization of 3–7 days versus 10 days in the DS or MVC group. Moreover, no statistically significant difference in sensory recovery was found in cases receiving postoperative sensory re-education versus those not receiving in the DS or MVC group. An early mobilization does not seem to have a negative impact on the final outcome after digital
nerve reconstruction. The effect of sensory re-education after digital nerve reconstruction should be reconsidered.

Key words: nerve regeneration, peripheral nerve, digital nerve, sensory re-education, immobilization, digital, direct suture, muscle-in-vein conduits