摘要
目的评价选择性臂丛神经根切断治疗上肢痉挛性脑瘫的远期疗效。方法对1997年3月—2002年1月间施行选择性臂丛神经根切断术治疗上肢痉挛性脑瘫的患者,进行随访并对远期功能进行评价,采用Lazareff肌张力分级标准评定临床效果。结果16例17侧获得随访,随访时间为5.0～9.7年,平均8.6年。手术方式为选择性臂丛神经根全根切断10侧,部分切断2侧,高选择性分束切断5侧;其中切断神经根为颈_63次,颈_816次。术后远期疗效优3例,有效5例,无效8例9侧。结论选择性臂丛神经根切断治疗上肢痉挛性脑瘫远期大多数疗效下降和无效,但术前严格选择痉挛较局限的病例、术中进行高选择性臂丛神经根分束切断、术后坚持长期康复训练仍然能获得较好的疗效。
Objective To evaluate the long-term effect of selective brachial plexus rhizotomy in the treatment of spastic cerebral palsy. Methods Twenty-one patients（22 sides） who had undergone selective brachial plexus rhizotomy due to upper extremity spastic cerebral palsy from March 1997 to January 2002 were followed-up. Based on the Lazareff muscular tension criteria, their clinical effect was evaluated. Then the factors relatedto the clinical effect were analyzed. Results Sixteen patients （ 17 sides） had sufficient follow-up. Their mean age at surgery was 18 years old and their mean follow-up time was 8.6 years ranging from 5 to 9.7 years. Ten patients had selective whale-root rhizotomy of the brachial plexus, 2 had selective partial-root rhizotomy and 5 had highly-selective nerve-tract rhizotomy. C6 rhizotomy was carried out in 3 sides and C8 rhizotomy in 16 sides. The long-term effect was rated as excellent in 3 patients, effective in 5 patients and ineffective in 8 patients（9 sides）. Conclusion The long-term effect of selective brachial plexus rhizotomy for treatment of upper extremity spastic cerebral palsy was generally poor. However, Good effect can still be obtained if highly-selective nerve-tract rhizotomy was carried out in those whose muscle spasm was localized and who had long-term and strict postoperative functional rehabilitation.
出处
《中华手外科杂志》
CSCD
北大核心
2007年第6期358-360,共3页
Chinese Journal of Hand Surgery
关键词
臂丛
脑性瘫痪
肌痉挛
随访研究
选择性脊神经后根切断术
Brachial plexus
Cerebral palsy
Muscle spasm
Follow-up studies
Selective posterior rhizotomy
