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1974以来用手术治疗急慢性神经痛37例,其中LL 3例、BL 11例、BB 9例、BT 8例、TT 6例;男性32例、女性5例;年龄21～45岁;病期5年以内的2l例,6～10年13例,lO年以上3例.神经痛的部位:耳大神经2例,尺30例,正中3例,腓总2例。切开皮肤,分离,切口长度一般超过肿大段的两端。分离出神经干,用尖刀或鞘囊刀在鞘膜上纵切O.5cm,然后用眼科尖钳分离扩大切口,长度应超过肿大段的两端,并将肿大的神经束与鞘膜全部分离。急性肿大神经,可见神经干鞘膜充血、水肿,呈梭形或园柱形,与周围组织没有粘连,粗细均匀。切开可松解减压、止痛,改善神经干的血循环。神经痛反复发作,保守治疗无效的病例.均可手术。术后31例神经痛完全消失(83.78％),5例减轻(13.52％),无效1例(2,7％)。手术除可减轻痛疼,还可防止功能障碍和畸残加剧。
There were 37 cases of acute and chronic neuralgia treated by surgery since 1974, including LL 3, BL 11, BB 9, BT 8, TT 6; 2l cases in years, 6 to 10 years in 13 cases, lO years in 3 cases.Nerve pain in the site: 2 cases of auricular nerve, ruler in 30 cases, the median 3 cases, 2 cases of the common peroneal. Cut the skin, separation, incision length generally larger than the ends of the enlarged segment. Nerve stem was separated and cut with a sharp knife or sheath knife in the sheath longitudinally 0.5 cm, and then with an ophthalmic sharp forceps to expand the incision, the length should be larger than the ends of the enlarged segment, and the enlarged nerve bundle and sheath All separated. Acute enlargement of the nerve, showing nerve sheath dry membrane congestion, edema, fusiform or cylindrical, with no adhesions around the organization, uniform thickness. Cut open decompression, analgesic, improve neural stem blood circulation. Recurrent neuralgia, conservative treatment of ineffective cases. Can be surgery. After operation, 31 cases of neuralgia completely disappeared (83.78%), 5 cases were relieved (13.52%), 1 case was ineffective (2,7%). In addition to reducing pain and surgery, but also to prevent dysfunction and malformation worse.