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目的介绍放射性臂丛损伤的诊治经验。方法对放射性臂丛损伤,就其诊断、治疗进行回顾性分析,并比较单纯神经松解与神经松解加肌皮瓣覆盖两种手术方法的疗效。结果临床治疗9例,术后随访2～5年。单纯神经松解组在术后3年随访,感觉及运动与术前相比无改善或加重,虽主诉疼痛较术前缓解,但仍需每日多次服用止痛药缓解疼痛。神经松解加肌皮瓣覆盖组2年随访,3例疼痛消失,2例有轻度疼痛,间断口服止痛药缓解,上肢肌群肌力为Ⅲ～Ⅳ级,手内在肌无明显恢复。结论在治疗上首先应以预防为主。对于伴有严重疼痛的病例,神经松解的同时以局部肌皮瓣覆盖是一种较好的对症治疗方法,而单纯神经松解术对缓解疼痛无效。
Objective To introduce the diagnosis and treatment of radiological brachial plexus injury. Methods Radiofibrous brachial plexus injuries were retrospectively analyzed for their diagnosis and treatment. The curative effects of simple nerve release and nerve release combined with myocutaneous flap coverage were compared. Results The clinical treatment of 9 cases, followed up for 2 to 5 years. The simple nerve release group was followed up for 3 years after operation. There was no improvement or aggravation of sensory and motor symptoms compared with that before operation. Although the chief complaint of pain was relieved preoperatively, pain reliever was still required to be taken multiple times daily. After 2 years of follow-up, 3 cases of pain disappeared, 2 cases of mild pain and intermittent oral pain reliever relieved. Muscle strength of upper limb muscle group was grade Ⅲ ~ Ⅳ, no significant recovery of internal hand muscles. Conclusion The first treatment should be based on prevention. For cases with severe pain, local neurocutaneous flap coverage is a good symptomatic treatment of neurolysis, while simple neurolysis is not effective in relieving pain.