前臂及手掌丛状神经纤维瘤的显微外科治疗

Yang Li, Yuehua Liu, C. Bai, J. Teng, Tenglong Hu, Li Song, Ming-wu Zhou
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引用次数: 0

摘要

目的探讨显微手术治疗前臂、手掌丛状神经纤维瘤的临床效果。方法2014年1月~ 2017年6月,对6例前臂、手掌的PN采用神经血管移植、镜下分离吻合等显微手术切除。男4例,女2例,平均年龄9.2岁(范围2 ~ 18岁)。右前臂及手掌正中神经、尺神经及其分支病变1例,右前臂及手掌正中神经及其分支病变2例,左前臂及手掌正中神经及其分支病变2例,左前臂及手掌尺神经及其分支病变1例。通过门诊随访评估患者术后功能及感觉。结果6例患者病理结果均显示PN,切口基本愈合。随访6 ~ 36个月,平均18个月。所有切口未见明显瘢痕形成。其中,最年轻患者掌部PN术后复发,第二次手术切除。其余5例患者随访无复发。中尺侧PN患者患肢每个指尖2点分辨力为2 ~ 5 mm,平均3.30 mm;中位PN患者患肢拇指、指关节、中指、无名指2点分辨力为2 ~ 5 mm,平均2.95 mm;尺侧PN患者患肢无名指和小指2点分辨力为3 ~ 4 mm,平均为3.50 mm。根据美国骨科足踝外科学会(AOFAS)制定的相关评价标准,5例前臂及手部功能为优,1例为良。结论应用显微外科技术治疗前臂掌部PN可有效分离肿瘤与神经纤维,有效保护正中神经、尺神经分支及其血液循环,防止复发,减少术后神经损伤。关键词:前臂;棕榈;丛状神经纤维瘤;正中神经;尺骨神经;显微外科技术
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Microsurgical treatment of the plexiform neurofibroma in the forearm and palm
Objective To explore the clinical effect of microsurgery in the treatment of the tumor which was diagnosed with the plexiform neurofibroma (PN) of the forearm and palm. Methods From January, 2014 to June, 2017, 6 cases of the PN in the forearm and palm were removed by microsurgery such as neurovascular transplantation, separation and anastomosis under microscope, etc. There were 4 males and 2 females, with an average age of 9.2 (range, 2-18) years. There was 1 case with PN of the median nerve, ulnar nerve and their branches in the right forearm and palm, 2 cases with PN of the median nerve and its branches in the right forearm and palm, 2 cases with PN of the median nerve and its branches in the left forearm and palm, and 1 case with PN of the ulnar nerve and its branches in the left forearm and palm. The postoperative function and feeling of the patients were evaluated by outpatient followed-up. Results The pathological results of 6 patients all showed PN, and their incisions healed primarily. The patients were followed-up for 6 to 36 months, with an average of 18 months. No obvious scar formation was observed in all incisions. Among them, PN of the palmar of the youngest patient recurred after the operation, and it was resected in a second operation. The remaining 5 patients had no recurrence during follow-up. The 2 point resolution of each fingertip of the affected limb of the patients who had median and ulnar PN was 2-5 mm, with an average of 3.30 mm; the 2 point resolution of the thumb, indicator, middle and ring fingers of the affected limbs of the patients who had median PN was 2-5 mm, with an average of 2.95 mm; the 2 point resolution of the ring and little fingers of the affected limbs of the patients who had ulnar PN was 3-4 mm, with an average of 3.50 mm. According to the related evaluation criteria made by the American Orthopedic Foot and Ankle Surgery Society (AOFAS) , the results of the forearm and hand functions were excellent in 5 cases, good in 1 case. Conclusion The application of microsurgical techniques in the treatment of PN in the forearm and palm can be effective separation of tumor and nerve fibers, effectively protect the branches of the median nerve and ulnar nerve and their blood circulation, prevent recurrence and reduce nerve damage after operation. Key words: Forearm; Palm; Plexiform neurofibroma; Median nerve; Ulnar nerve; Microsurgical technique
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来源期刊
CiteScore
0.50
自引率
0.00%
发文量
6448
期刊介绍: Chinese Journal of Microsurgery was established in 1978, the predecessor of which is Microsurgery. Chinese Journal of Microsurgery is now indexed by WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 1.731 in 2017, ranking the third among all journal of comprehensive surgery. The journal covers clinical and basic studies in field of microsurgery. Articles with clinical interest and implications will be given preference.
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