范少地，闫自强，雷海录，周风金.关于周围神经适应肢体缓慢延长的电生理研究[J].中华物理医学与康复杂志,2004,(2):
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| 关于周围神经适应肢体缓慢延长的电生理研究 |
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| DOI： |
| 中文关键词: 肢体延长 神经 亚临床损害 修复 |
| 英文关键词: Tibia lengthening Nerve Subclinical lesion Repair |
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| 中文摘要: |
| 目的对患者经肢体延长术前及术后进行电生理检查，以研究患者肢体延长后其周围神经是否存在亚临床损伤及其修复转归机制，同时探讨肢体延长与神经损伤间的关系，为临床肢体延长术提供检测方法并指导治疗。 方法对23例（共42侧肢体）患者肢体以1mm/d的速度进行牵伸延长，整体延长幅度为4~10 cm。并分别于术前、术后2个月、3个月、2年对患者下肢进行复合感觉诱发电位（CSEP）检查，并对其症状、体征进行临床评定，将所得电生理指标与延长前及同期门诊正常人测量值进行对照比较。 结果除1例患者延长幅度至9.5 cm时出现小腿及足背麻木症状外，其余患者在肢体延长术结束后均无明显神经损伤症状，但下肢的复合感觉诱发电位检测表明患者存在亚临床损伤，且该异常表现于延长结束后3个月基本趋于正常，于延长后2年基本恢复。 结论当对患者肢体进行缓慢延长时，其周围神经具有良好的适应性；在患者不出现临床神经损伤症状的前提下，可以大幅度延长其肢体长度。 |
| 英文摘要: |
| Objective To observe if subclinical lesion exists during and after tibia lengthening and investigate the repair mechanism of the nerve. MethodsTwenty-three cases（with 42 tibia） were lengthened by traction with the velocity of 1mm/d. The somatosensory evoked potentials (SEP) induced by stimulation of tibial nerve were recorded before operation and 2,3 months and 2 years after operation. The tibia was lengthened for a total of 4~10cm. ResultsAll cases had no significant symptoms except for 1 case with mild symptoms of nerve lesion when his tibia was lengthened for 9.5cm. However, the subclinical lesion was found by SEP record in all the cases, and this lesion could be repaired mostly in 3 months and completely recovered in 2 years. ConclusionThe peripheral nerves have good adaptability to tibia lengthening with a velocity of 1mm/d and the tibia could be lengthened to a great extend as long as there were no clinical symptoms manifestated. |
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