同种异体神经移植治疗锐性臂丛神经缺损5例临床研究

Nerve allograft transplantation in treatment of lacerated brachial plexus defects:A clinical analysis of 5 cases

  • 摘要: 目的 报告5例同种异体神经移植修复人体臂丛神经锐性切割性缺损的疗效。方法 应用去细胞同种异体神经移植修复5例臂丛神经锐性切割性缺损患者,自2004年2月-2009年3月共移植同种异体神经8根,长度为2-4cm(平均3.1cm),修复臂丛颈5根部2根,颈6根部3根,上干1根,中干1根,上干后股1根。术后对患者感觉、运动功能复查,并行神经超声、MRI及肌电图检查评估。结果 术后5例患者随访14-74个月,平均40.4个月。优3例,良1例,无变化1例;在移植的8根神经中,优4根,良2根,无变化2根。结论 应用化学去细胞同种异体神经移植修复人体臂丛神经锐性缺损具有良好的疗效,为其进一步临床应用奠定了基础。

     

    Abstract: Objective To report the effect of chemically extracted acellular nerve allograft(CEANA) on lacerated brachial plexus nerve defects in 5 cases.Methods Five patients with lacerated brachial plexus nerve defects were treated with CEANA from Feb.25,2004 to Mar.5,2009 in our hospital.Eight nerve allografts were used with an average length of 3.1cm(ranging 2-4cm) to repair defects of C5,C6,upper trunk,middle trunk and posterior division of the upper trunk in 2,3,1,1 and 1 patients,respectively.The patients were followed up for sensation and motion with brachial plexus ultrasonography,MRI and EMG,respectively.Results The mean follow-up time was 40.4months(ranging 14-74months).Excellent and good outcome was achieved in 3 and 1 patients,respectively,with no improvement observed in 1 patient.Of the 8 nerve allografts used,4 functioned excellently and 2 functioned well.Conclusion CEANA can be used in repair of lacerated brachial plexus nerve defects with a rather good therapeutic effect,thus laying a foundation for its further application in clinical practice.

     

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