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-  2015 

正常S1神经作为动力神经切断后对下肢功能的远期影响

DOI: doi:10.7507/1002-1892.20150184

Keywords: S1神经, 动力神经, 下肢功能, 功能重建

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Abstract:

目的评价正常S1神经根作为动力神经切断后对下肢功能的远期影响。 方法2007年1月-2011年12月收治行S1神经根移位重建膀胱功能手术的脊髓圆锥损伤后膀胱功能障碍患者47例。男43例,女4例;年龄22~66岁,平均40.7岁。脊椎骨折部位:L1 33例,L2 5例,L3 2例,T12、L1 3例,L1、L2 1例,L1、L3 1例,L1、L4 1例,L2、L3 1例。脊髓损伤后4~24个月,平均8个月行S1神经根移位重建膀胱功能手术。术前尿流动力学均显示弛缓性膀胱;下肢屈屈踝肌力4级5例,5级42例。 结果术后第2天检查屈屈踝肌力,31例与术前肌力水平一致,16例神经切断侧相关肌力轻微下降约半级。47例均获随访,随访时间3~8年,平均5.1年。术后2周行神经电生理检查,大部分患者表现有神经源性损害,其中19例出现术侧胫神经最大波幅降低,13例术侧腓总神经最大波幅降低,9例术侧胫神经、腓总神经最大波幅均降低。除术后2周术侧腓总神经潜伏期与术前比较差异无统计学意义(t=—1.881,P=0.093)外,其余各神经电生理指标手术前后比较差异均有统计学意义(P<0.05)。随访期间未见下肢屈屈踝肌力减退,行走能力均较术前无下降。 结论S1神经切断后对下肢功能无明显影响,S1神经可作为安全的动力神经用于下肢功能重建

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