目的 探讨高频超声检查在上肢神经损伤中的应用价值.方法 对31例临床确诊为上肢单根神经损伤患者,根据超声检查分成保守治疗组和手术治疗组.手术组(19例)均行神经探查修复术,并以术中探查结果为准计算术前超声的诊断符合率;保守治疗组(12例)和手术组术后均予口服营养神经药物治疗,定期随访超声检查.结果 保守治疗组早期超声图像表现:神经走行弯曲,但神经外膜清晰可见,局部水肿.手术组术前超声图像表现:神经回声带连续性部分中断或完全中断,损伤区为无回声或低回声结构,神经近端直径增粗.手术组与超声诊断完全符合15例,符合率为78.9%;保守治疗组中10例神经功能恢复良好,2例保守治疗无效而行手术治疗.结论 高频超声检查对上肢周围神经损伤有很好的临床应用价值,并对临床治疗和随访有指导意义.%Objective To evaluate the diagnostic value of high resolution ultrasonography in upper limb nerve injuries. Methods Thirty-ong patients who were diagnosed with single nerve injury of the upper limb were divided into surgical treatment group and conservative treatment group according to the ultrasonographic findings. The surgical treatment group ( 19 cases) underwent radial nerve exploration and repair. Intraoperative findings were used to verify the accuracy of preoperative ultrasonographic diagnosis. Patients in the conservative treatment group (12 cases) and surgical treatment group postoperatively received oral administration of neurotrophic medicines and regular follow-up of with high resolution ultrasound examination. Results The ultrasonographic images of the conservative treatment group showed that the course of the nerve was curving,epineurial structure was still intact, and there was local edema. Preoperative ultrasonographic images of the surgical treatment group showed that the ultragenic signals of the nerve was completely or partially interrupted. The lesion site was hypoechogenic or non-echogenic. The diameter of the proximal nerve end was increased. Surgical exploration confirmed the accuracy of ultrasonographic diagnosis in 15 cases, with an accuracy rate of 78.9%. In the conservative treatment group, 10 patients had good nerve function recovery, while 2 cases had poor recovery and went on for surgical treatment. Conclusion High resolution ultrasound examination has a good clinical value in diagnosis of upper extremity peripheral nerve injuries. It is of guiding significance for treatment and follow-up.
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