王涛 顾玉东 陈德松 张高孟 成效敏 徐建光 陈亮 张丽银 蔡佩琴 虞聪 沈丽英 200040上海医科大学附属华山医院手外科 中华手外科杂志 1999 0 0 1


    关键词：臂丛；创伤和损伤；诊断；鉴别 期刊 zhswkzz 0 臂丛损伤与颈神经卡压 fur -->


    

【摘要】 目的 探讨臂丛多节段损伤的诊断和处理。方法 对1997年5月至1998年5月经手术证实为臂丛损伤的191例病史进行分析。臂丛多节段损伤的概念，是指在臂丛高位损伤的前提下，隔开一段正常神经的下段神经同时存在损伤。结果 191例中，臂丛多节段损伤有54例，发生率为28.3%。术前多未能作出正确的诊断，而是通过手术探查和术中神经-肌电图检测方能确诊。结论 多节段损伤是臂丛损伤中一种常见的病理类型，术前要作出正确的诊断非常困难，故在臂丛神经探查术中要重视术中神经-肌电图的应用。

Diagnosis and treatment of multiple level brachial plexus injuries WANGTao, GU Yudong, CHEN Desong,et al. Department of Hand Surgery,Huashan Hospital , ShanghaiMedical University, Shanghai 200040

    【Abstract】 Objective To investigate the diagnosis and treatment ofmultiple level brachial plexus injuries. Methods The clinica l data of191 cases of brachial plexus injuries treated between May 1997 and May 1998 we reanalyzed. Multiple level brachial plexus injury was defined as the existence of injury tothe distal part of the plexus which was spaced by a segme nt of normal nerve from theinjured proximal part of the plexus. Result s Multiple level brachialplexus injury was found in 54 of 191 cases, with an inci dence of 2 8.3 %. Thepreoperative diagnosis of multiple level brachial plexus injury was very difficult. Atpresent, intraoperative exploration and electrophysiological monitoring are the mosteffective methods for diagnosis of multiple level brachi al plexus injury. Conclusions Multiplelevel brachial plexus in jury is a common pathological type. Emphasis should be laid oncareful surgical exploration and intraoperative electrophysiological monitoring.

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