Nerve injuries sustained during warfare PART I - EPIDEMIOLOGY
Nerve injuries sustained during warfare PART I - EPIDEMIOLOGY
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DOI：
10.1302/0301-620x.94b4.28483
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发表时间：
2012-04-01
影响因子：
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通讯作者：
Stewart, M. P. M.
中科院分区：
文献类型：
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作者：
Birch, R.;Eardley, W. G. P.;Stewart, M. P. M.
我们描述了261周围神经损伤持续在战争中受伤的100名连续服务的男性和女性在伊拉克和阿富汗。他们的平均年龄为26.5岁（18.1至42.6岁），损伤与首次审查之间的中位间隔为4.2个月（平均8.4个月（0.36至48.49）），中位随访时间为28.4个月（平均20.5个月（1.3至64.2））。神经损害主要为局灶性长时间传导阻滞/神经失用症116例（45%），轴突断伤92例（35%），神经断伤53例（20%），均匀分布于上下肢。爆炸占164例（63%）：213例（82%）神经损伤与开放性伤口有关。70例患者有两条或两条以上主要神经损伤。尺神经、腓总神经和胫神经损伤最常见。在69例患者中，神经病变水平存在血管损伤、骨折或两者兼而有之。50例患者存在严重组织缺损：18例患者至少需要截肢一条肢体。本文对36例持续严重神经病理性疼痛的患者进行了回顾性分析，并对神经损伤的深度和分布、相关损伤和神经病理性疼痛综合征进行了介绍。
We describe 261 peripheral nerve injuries sustained in war by 100 consecutive service men and women injured in Iraq and Afghanistan. Their mean age was 26.5 years (18.1 to 42.6), the median interval between injury and first review was 4.2 months (mean 8.4 months (0.36 to 48.49)) and median follow-up was 28.4 months (mean 20.5 months (1.3 to 64.2)). The nerve lesions were predominantly focal prolonged conduction block/neurapraxia in 116 (45%), axonotmesis in 92 (35%) and neurotmesis in 53 (20%) and were evenly distributed between the upper and the lower limbs. Explosions accounted for 164 (63%): 213 (82%) nerve injuries were associated with open wounds. Two or more main nerves were injured in 70 patients. The ulnar, common peroneal and tibial nerves were most commonly injured. In 69 patients there was a vascular injury, fracture, or both at the level of the nerve lesion. Major tissue loss was present in 50 patients: amputation of at least one limb was needed in 18. A total of 36 patients continued in severe neuropathic pain.This paper outlines the methods used in the assessment of these injuries and provides information about the depth and distribution of the nerve lesions, their associated injuries and neuropathic pain syndromes.