外伤性周围神经损伤后的修复方法:系统的文献综述。

Acta cirurgica brasileira Pub Date : 2025-02-24 eCollection Date: 2025-01-01 DOI:10.1590/acb401225
Naely Nobre Costa, Jennifer Ferreira Dos Santos, Maria Fernanda de Almeida Cavalcante Aranha, Erik William Farias Coelho, Victor Leno Silva Paes, Rita de Cássia Silva de Oliveira
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引用次数: 0

摘要

目的:识别和描述外伤性周围神经损伤最常用的手术修复方法,并强调外周神经损伤的原因和最常见的创伤神经。方法:这是一篇系统文献综述,采用系统评价和荟萃分析首选报告项目(PRISMA)的建议。这些搜索在PubMED中进行,时间窗口从2018年1月到2022年12月。结果:共收集到3687篇文献,经纳入、排除筛选及偏倚风险分析,还剩34篇文献。观察到损伤的年龄和神经修复的类型对患者的恢复有很大影响。最常见的创伤修复方法是神经松解术、直接缝合、移植和神经移植。在这四种手术中,目前首选直接缝合。结论:周围神经损伤可采用多种修复方法,以直接缝合为主。然而,在修复延迟或第一次治疗方案失败的情况下,神经移植被证明是一个区别,这表明每种方法都将根据每种情况的适应症使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Repair methods in peripheral nerves after traumatic injuries: a systematic literature review.

Purpose: To identify and describe the most used surgical repair methods for traumatic injuries to peripheral nerves, as well as highlight the causes of trauma to peripheral nerves and the most prevalent traumatized nerves.

Methods: This is a systematic literature review using the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The searches were carried out in PubMED, in the time window from January 2018 to December 2022.

Results: In total, 3,687 articles were collected, of which, after applying the inclusion and exclusion filters and analyzing the risk of bias, 34 articles remained. It was observed that the age of the injury and type of nerve repair strongly influence the recovery of patients. The most identified trauma repair procedures were neurolysis, direct suturing, grafting, and nerve transfer. Among these four procedures, direct suturing is currently preferred.

Conclusion: Several repair methods can be used in peripheral nerve injuries, with emphasis on direct suturing. However, nerve transfer proves to be a differential in those cases in which repair is delayed or the first treatment options have failed, which shows that each method will be used according to the indication for each case.

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