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35 cases of peripheral nerve injury were sumed up in this article. Among them,good result is in 60%.Author considers that epineurorrh- aphy still has a certain merit,for there is not a accurate method to distinguish properties of the nerve tract fibers.Nerve injury associated with fractures and dislocations,it should not be missed in diagnosis.It is important to prevent nerve injury on medical care.The treatment of highvlevel nerve injury should be approached in further. 本文总结了35例周围神经损伤病例,平均随访2.1年,优良率为60%。疗效尚属满意。通过病例分析认为:在目前对神经束纤维的性质无精确判断方法时,神经外膜缝合法尚有一定的优点;骨折脱位合并神经损伤应防止漏诊;医源性神经损伤重在预防;高位神经损伤的治疗有待进一步探讨。 Defects of sixteen peripheral nerve were re-paired by skeletal muscle bridging from December1986 though December 1989. Satisfactory resultswere achieved after follow-up for 8-31 months.The key point of this operation were proper explo-ration and exposure of the nerve stumps ,thoroughresection of the cicatricial tissues from the stumpsproper chois of muscular fascicle for bridging, pro-viding a good blood supply to the muscle strip, andcorrect suture of the nerve under microscope. Irri-gation of the operative... Defects of sixteen peripheral nerve were re-paired by skeletal muscle bridging from December1986 though December 1989. Satisfactory resultswere achieved after follow-up for 8-31 months.The key point of this operation were proper explo-ration and exposure of the nerve stumps ,thoroughresection of the cicatricial tissues from the stumpsproper chois of muscular fascicle for bridging, pro-viding a good blood supply to the muscle strip, andcorrect suture of the nerve under microscope. Irri-gation of the operative field with hydrocortisonecould play some roles of decreasing the postopera-tive local inflammation, edema, adhesion, and scarformation. 1983年12月~1989年12月,对16例周围神经缺损的病员进行了肌桥术修复。经8个月~31个月随访,效果满意。认为彻底切除神经两断端间瘢痕组织,选择正常骨骼肌束作桥接材料,在显微镜下进行肌膜与神经外膜的缝合,是手术成功的关键。 The natural fasciculation of a pe- ripheral nerve trunk is of instructive significance for the identification of the corresponding fascicles during operation. It is well known that the freeing and separation of a nerve tru- nk would disturb its blood circula- tion. However, the present study sho- ws that the blood supply of a nerve trunk is not obviously affected when it is separated through natural fa- scicles. There is a rich blood supply system in each natural nerve fascicle, and the separation along the... The natural fasciculation of a pe- ripheral nerve trunk is of instructive significance for the identification of the corresponding fascicles during operation. It is well known that the freeing and separation of a nerve tru- nk would disturb its blood circula- tion. However, the present study sho- ws that the blood supply of a nerve trunk is not obviously affected when it is separated through natural fa- scicles. There is a rich blood supply system in each natural nerve fascicle, and the separation along the natural fascicles within its separable length would not disturb the blood supply of the separated fascicles. 应用微血管灌注透明法观察研究5具成人周围神经干标本.重点观察神经自然分束部位微血管形态和分支分布规律.神经干内有非常完兽的血供系统.手术中循神经自然分束进行追踪分离,不会对神经血供产生明显影响.但在张力下牵拉缝合神经,将对神经干血供产生严重影响.神经束膜缝合比神经外膜缝合更强调在无张力下进行.
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