【摘要】 目的 探讨外源性压迫因素所致腓总神经损伤的治疗方法。方法 回顾分析了我院1995年8月～2005年8月收治的单纯外源性压迫所致腓总神经损伤病人32例的临床资料，其外源性压迫因素有石膏边缘卡压、小夹板及压垫压迫、牵引架布托卡压和下肢被动长时间外旋压伤腓骨颈处等。27例行保守治疗，方法包括电针灸配合应用药物熏洗、理疗、按摩、药物等；手术治疗5例，方法包括切开腓管减压、彻底松解神经周围粘连较重的组织，甚至将神经外膜松解。结果 随访1～18个月,平均10个月，疗效优24例,良4例,可2例，差2例。2例差者均为病程超过6个月者，最终1例行肌腱移位，1例行踝关节融合术。结论 外源性压迫所致腓总神经损伤的治疗越早效果越好，早期应以保守治疗为主，保守治疗超过3个月神经功能恢复停止者应行神经松解术治疗。
【关键词】 神经卡压综合征 腓神经 治疗学
［ABSTRACT］ObjectiveTo explore the therapy of injury of common peroneal nerve caused by external compression. MethodsThirtytwo patients with injury of common peroneal nerve, caused by external compression, treated in our hospital (August, 1995-August, 2005) were reviewed. The reasons of compression included：plaster, small splint and pad, the cloth support of the traction rack, and the neck of fibula compressed due to longtime external rotation. Conservative therapy was carried out in 27 patients, which included electric acupuncture matching with herbal fumigation and bathing, physiotherapy, massage and medication. Surgery was done in five patients. The procedures included decompression of fibula canal, adhesiolysis of the tissue around the nerve, or decompression of the epineurium. ResultsThe followup time (average) was 1-18 months (10 months). The therapeutic efficacy was: excellence in 24 cases, good in four, fair in two, and poor in another two. The course of both the two patients with poor outcome was over six months, and tendon transfer was performed in one case and ankle fusion in another.ConclusionEarlier treatment of the common peroneal nerve injury caused by external compression will bring better result. The conservative treatment should be adopted in early stage. Neurolysis should be done for those who have been treated conservatively for over three months without signs of recovering.
［KEY WORDS］nerve entrapment syndrome; peroneal nerve; therapeutics
腓总神经卡压综合征,广义讲是指腓总神经在腘窝自坐骨神经分出后至进入小腿前外侧肌群行径内任何部位受压所导致的一系列症候群。压迫因素大致分为两种：外源性和内源性。内源性主要指由于膝关节部位的骨折脱位压迫、腓骨颈等部位的肿瘤压迫所致的腓总神经损伤。外源性的压迫因素较多，临床上最常见的是下肢石膏固定引起,石膏固定过紧或固定后患肢伤处继续肿胀,造成对腓总神经的卡压，另外还有一些其他常见的外源性卡压因素。1995年8月～2005年8月,我院共收治外源性压迫所致的腓总神经损伤病人32例,现将其临床资料报告如下。
1 资料和方法
1.1 一般资料
本组32例,男23例,女9例；年龄15～72岁,平均35岁。致伤原因：石膏压迫16例,牵引架布托卡压3例，被动体位(长时间患侧卧位)压迫5例,小夹板及压垫压迫4例，下肢牵引不当、牵引弓脚压迫3例,长期下蹲屈膝体位1例。发现症状至就诊时间1 d～6个月。
外源性压迫致腓总神经损伤的治疗
2025-04-30
外源性压迫致腓总神经损伤的治疗.doc
将本文的Word文档下载到电脑
下载失败或者文档不完整，请联系客服人员解决！
