Study on the motor and sensory recovery of upper limb in the treatment of upper extremity nerve injury with combined suture of epineurium and perineurium

Yang Chen, Jun Chen, J. Guan
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Abstract

Objective To investigate the clinical efficacy of combined suture of epineurium and perineurium on motor and sensory recovery of upper limbs with nerve injury. Methods From January 2017 to December 2017, 80 patients with upper limb nerve injury were retrospectively analyzed. Forty patients underwent epineurial suture repair (group A), and another 40 patients underwent combined epineurial and perineurial suture repair (group B). After 6 months of rehabilitation training, the clinical efficacy of nerve function, electrophysiological indexes and the improvement of quality of life of the two groups were compared and analyzed. Results The recovery of nerve function was compared between the two groups 6 months after operation. According to motor sensory grading criteria established by British Medical Research Institute, limb function was evaluated as excellent in 17 cases, good in 10 cases, fair in 6 cases and poor in 7 cases for group A with the excellent and good rate being 67.5%; evaluated as excellent in 22 cases, good in 11 cases, fair in 5 cases and poor in 2 cases for group B with the excellent and good rate being 82.5%. χ2 test showed that the excellent and good rate of group B was significantly higher than that of group A (P<0.05). The electrophysiological indexes including nerve conduction velocity and amplitude were better in group B than in group A (P<0.05). According to the quality of life assessment criteria established by WHO, the psychological function, social function, physical function and quality of life of the two groups were compared and analyzed. The results showed that the improvement degree of quality of life in group B was better than that in group A, and the difference was statistically significant (P<0.05). Conclusion The combined suture of epineurium and perineurium for nerve repair in patients with upper limb nerve injury can achieve satisfactory clinical efficacy. The motor and sensory functions of affected limbs recover well and can be widely used in clinic. Key words: Upper extremity; Peripheral nerves; Nerve suture; Motor sensory function of limbs
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神经外膜和会阴联合缝合治疗上肢神经损伤的上肢运动和感觉恢复研究
目的探讨神经外膜与神经周围膜联合缝合对神经损伤上肢运动感觉功能恢复的临床疗效。方法回顾性分析2017年1月~ 2017年12月收治的80例上肢神经损伤患者的临床资料。40例患者行神经外膜缝合修复术(A组),另40例患者行神经外膜与神经周围联合缝合修复术(B组)。经过6个月的康复训练后,比较分析两组患者神经功能、电生理指标的临床疗效及生活质量的改善情况。结果比较两组术后6个月神经功能恢复情况。根据英国医学研究所制定的运动感觉评分标准,A组肢体功能评分优17例,良10例,一般6例,差7例,优良率为67.5%;B组优22例,良11例,一般5例,差2例,优良率为82.5%。χ2检验显示,B组优良率显著高于A组(P<0.05)。B组神经传导速度、振幅等电生理指标优于A组(P<0.05)。根据WHO制定的生活质量评价标准,对两组患者的心理功能、社会功能、身体功能及生活质量进行比较分析。结果显示,B组患者生活质量改善程度优于A组,差异有统计学意义(P<0.05)。结论神经外膜与神经会膜联合缝合用于上肢神经损伤患者的神经修复可取得满意的临床疗效。患肢运动和感觉功能恢复良好,可广泛应用于临床。关键词:上肢;周围神经;神经缝合;四肢的运动感觉功能
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