武警医学2025，Vol.36Issue(9)：774-777,4.
高选择性周围神经部分切断术治疗上肢痉挛性偏瘫的疗效
Therapeutic effect of highly selective partial peripheral neurectomy for upper limb spastic hemiplegia
何心 1彭磊 1杨书哲 1秦至臻 2聂庆彬 2毛更生 2孙建军1
作者信息
- 1. 100050,首都医科大学附属北京友谊医院神经外科
- 2. 100039 北京,解放军总医院第一医学中心神经外科医学部
- 折叠
摘要
Abstract
Objective To evaluate the efficacy of highly selective partial neurectomy(HSPN)for upper limb spastic hemiple-gia.Methods A retrospective analysis was conducted on 29 patients with upper limb spastic hemiplegia who underwent HSPN,with a follow-up period of 6 months.The muscle tone,muscle strength,pain condition,and activities of daily living of the patients at different time points before and after the surgery were compared.Results The muscle tone scores showed that the elbow flexor tone at 1 week(1.48±0.51)and 6 months(2.21±0.73)after surgery were lower than preoperative levels(3.93±0.80),and the difference was statis-tically significant(P<0.05).The muscle tone of the flexor wrist muscles was also lower at 1 week(1.41±0.50)and 6 months(1.69±0.81)after surgery than preoperative levels(4.13±0.71),and the difference was statistically significant(P<0.05).The wrist flexor tone at 6 months increased compared to 1 week after surgery,but remained significantly lower than preoperative levels.Muscle strength scores indicated that elbow flexor strength at 1 week postoperatively(3.14±0.35)decreased compared to preoperative levels(3.55±0.51),and increased at 6 months postoperatively(3.34±0.48),but the differences were not statistically significant.Wrist flexor strength at 1 week postoperatively(2.41±0.57)was significantly lower than preoperative levels(3.28±0.80)(P<0.05),and increased at 6 months postoperatively(2.97±0.73)compared to 1 week(P<0.05).Barthel Index scores at 6 months(84.86±19.41)were signif-icantly higher than both preoperative(75.86±20.58)and 1 week postoperative values(77.86±19.62).Among 8 patients with preopera-tive pain,pain was gradually alleviated at 1 week and 6 months after surgery,and 7 patients developed postoperative pain,but the pain was relieved at 6 months after surgery.Conclusions HSPN can reduce the muscle tone of patients with spastic hemiplegia while preser-ving the voluntary motor function,improving the activities of daily living and relieving preoperative pain,and it is an effective surgical treatment method.关键词
偏瘫/痉挛/神经切断/肌张力Key words
hemiplegia/spasm/neurectomy/muscle tone分类
医药卫生引用本文复制引用
何心,彭磊,杨书哲,秦至臻,聂庆彬,毛更生,孙建军..高选择性周围神经部分切断术治疗上肢痉挛性偏瘫的疗效[J].武警医学,2025,36(9):774-777,4.
