[1]杨晓东,陈煜辉,麦奇光,等.腹腔镜下神经松解术治疗骨盆骨折合并腰骶干神经损伤的初步临床疗效评估[J].中华老年骨科与康复电子杂志,2022,(01):4-9.[doi:10.3877/cma.j.issn.2096-0263.2022.01.002]
 Yang Xiaodong,Chen Yuhui,Mai Qiguang,et al.The effectiveness and feasible of laparoscopic neurolysis for the treatment of pelvic fracture combined lumbosacral trunk injury[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2022,(01):4-9.[doi:10.3877/cma.j.issn.2096-0263.2022.01.002]
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腹腔镜下神经松解术治疗骨盆骨折合并腰骶干神经损伤的初步临床疗效评估()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2022年01期
页码:
4-9
栏目:
髋部骨折
出版日期:
2022-02-05

文章信息/Info

Title:
The effectiveness and feasible of laparoscopic neurolysis for the treatment of pelvic fracture combined lumbosacral trunk injury
作者:
杨晓东陈煜辉麦奇光李涛朱振华樊仕才
510630 广州,南方医科大学第三附属医院骨科中心创伤骨科
Author(s):
Yang Xiaodong Chen Yuhui Mai Qiguang Li Tao Zhu Zhenhua Fan Shicai.
Department of Traumatic Surgery, Center for Orthopaedic Surgery, the Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
关键词:
骨盆骨折 腰骶干神经损伤 神经减压 腹腔镜
Keywords:
Pelvic fractures Lumbosacral trunk injury Neurolysis Laparoscope
DOI:
10.3877/cma.j.issn.2096-0263.2022.01.002
文献标志码:
A
摘要:
目的 探讨腹腔镜下腰骶干神经松解术治疗骨盆骨折合并腰骶干神经损伤的初步临床疗效。方法 回顾性分析6例接受腹腔镜下腰骶干神经松解术的骨盆骨折合并腰骶干神经损伤患者的资料(2019年12月至2020年12月),其中男5例,女1例;平均年龄(36±15)岁(18~53岁);骨盆骨折Tile分型:C1.3型5例,C3型1例;受伤至手术时间:<3 w 2例,3 w~3月1例,>3月3例。术前根据英国医学研究会神经损伤委员会(BMRC)肌力标准:M0级4例,M1级2例。所有患者在术前均通过查体、骨盆增强CT联合磁共振神经成像(MRN)三维图像融合技术确诊为完全性腰骶干神经损伤且性质为软组织卡压。结果 6名患者中有4名顺利完成腹腔镜下神经松解,2名患者由于术中神经松解不彻底加行开放手术。腹腔镜手术平均时间(173±8)min;术中平均出血(112±56)ml。末次随访时肌力恢复情况:M4级3例, M3级1例,2例未恢复。结论 腹腔镜下神经松解术是一种精准、微创的手术方式,可能是骨盆骨折伴有软组织卡压的腰骶干神经损伤患者的有效治疗方案。
Abstract:
Objective To measure the effectiveness and feasible of laparoscopic neurolysis for the treatment of pelvic fracture combined lumbosacral trunk injury. Methods From December 2019 to December 2020, 6 patients with pelvic fracture combined lumbosacral trunk injury were received laparoscopic neurolysis (Male 5, female 1, mean age: 36±15). Tile classification of pelvic fracture: C1.3 of 5 cases, C3 of 1 cases, one patient was presented nerve injury post sacral-illiac screw fixation. The time before operation were: 2 cases less than 3 weeks, between 3 weeks and 2 month was 1 case, over 2 months were 3 case. The muscle strength of patients before operation were recorded according to the level of Nerve Injuries Committee of the British Medical Research Council (BMRC). M0 of 4 cases, M1 of 2 cases. All cases were diagnosed with soft tissue entrapment of lumbosacral trunk by physical examination and enhanced CT and magnetic resonance neurography (MRN) fusion technique. Results Four patients were underwent laparoscopic neurolysis successfully and 2 patients were underwent opening operation due to bony entrapment was observed intra-operatively. The mean operative time of laparoscopic neurolysis was (173±8) min and mean blood loss was (112±56) ml. The muscle strength at the endpoint of follow-up were M4 of 3 cases, M3 of 1 cases, no recover in 2 cases. Conclusions The laparoscopic neurolysisis a precise, minimally invasive method for the pelvic fracture combined soft tissue entrapment of lumbosacral trunk and the primary effectiveness is safe and sufficient.

相似文献/References:

[1]邓京骐,李涛,朱振华,等.改良LC-Ⅱ螺钉固定钉道的数字化分析与验证[J].中华老年骨科与康复电子杂志,2023,(03):129.[doi:10.3877/cma.j.issn.2096-0263.2023.03.001]
 Deng Jingqi,Li Tao,Zhu Zhenhua,et al.Digital analysis and optimization of the modified LC-Ⅱ screw fixation path[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2023,(01):129.[doi:10.3877/cma.j.issn.2096-0263.2023.03.001]

备注/Memo

备注/Memo:
基金项目:国家自然科学基金(81772428,82072411)
更新日期/Last Update: 2022-04-25