SURGICAL REPAIR OF PERIPHERAL-NERVE INJURY
SURGICAL REPAIR OF PERIPHERAL-NERVE INJURY
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DOI：
10.1002/mus.880130911
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发表时间：
1990-09-01
期刊：
影响因子：
3.4
通讯作者：
KLINE, DG
中科院分区：
文献类型：
--
作者：
KLINE, DG
在过去的 10 至 20 年中，放大技术、使用精细束间移植物进行修复以及术中功能电生理测量的发展对该领域产生了重大影响。二战期间及二战后确立的基本手术原则仍然是周围神经损伤手术修复的基础，但这些最新进展得到了很好的补充。对手术患者的选择以及手术时机进行了审查，重点是可疑横断和连续性病变之间的差异，以及对严重外周介入和影响神经的肿瘤的评论。不仅术前肌电图研究的重要性，而且术中使用连续性刺激和刺激以及记录病变的神经动作电位（NAP）的重要性也得到了强调。对神经松解术、NAP 记录、缝合、裂口修复和束间移植物修复等手术技术进行了回顾，并对结果进行了一些评论。国内外治疗更严重的外科神经问题的中心正在逐步发展。预计未来这些中心将能够提供有关平民神经损伤结果的改进数据。
Magnification, useof fine interfascicular grafts for repair, and development of intraoperative electrophysiologic measurements of function have had a substantial impact on this field in the last 10 to 20 years. Basic surgical principles established during and since World War II remain the foundation for surgical repair of peripheral nerve injury but have been complemented nicely by these more recent advances. Selection of patients for surgery, as well as the timing of such, has been reviewed with emphasis on the differences between suspected transections and lesions in continuity, as well as comments on serious peripheral enterpments and tumors affecting nerve. The importance of not only preoperative electromyographic studies but also the intraoperative use of stimulation and stimulation and recording of nerve action potentials (NAPs) for lesions in continuity has been stressed. Operative techniques such as neurolysis, NAP recordings, suture, split repair, and interfascicular graft repair have been reviewed and some commentary on results provided. There has been a gradual evolution of centers in this country and abroad for care of the more serious surgical nerve problems. It is anticipated that in the future, such centers will be able to provide improved data concerning results with civilian nerve injuries.