摘要目的 探讨成人臂丛根性损伤的临床分型. 方法 回顾性研究中山大学附属第一医院近5年来收治并手术探查证实、资料完整的成人臂丛根性损伤病例,分析、归纳出成人臂丛根性损伤临床分型. 结果 总结155例臂丛根性损伤病例,结合术前临床诊断与影像学诊断、术中探查与电生理学检测、术后随访研证,初步归纳出成人臂丛根性损伤临床分型,在上臂丛损伤(A型)、下臂丛损伤(B型)、全臂丛损伤(C型)三大类基础上,可进一步细分为七小类:①上臂丛损伤AⅠ型:C5、6根完全性损伤(撕脱或断裂),伴或不伴膈神经损伤；②AⅡ型:C5-7根完全性损伤；③AⅢ型:C5～7根完全性损伤伴C8、T1不全性损伤；④下臂丛损伤BⅠ型:C8、T1(或伴C7)完全性损伤；⑤BⅡ型:T1、C7、8完全性损伤伴C5、6不全损伤；⑥全臂丛损伤CⅠ型C5～T1根性撕脱伤；⑦CⅡ型:T1、C7、8根性撕脱伤伴C5、6根断裂. 结论 成人臂丛根性损伤可分为三大类七小类,但臂丛根性损伤临床分型的分布不平均,以上臂丛损伤(A型)(55.5％)和全臂丛损伤(C型)(40.6％)最为常见,下臂丛损伤(C型)最少(3.9％).上臂丛损伤A型中,AⅢ型最多(61.6％),AⅡ型次之(31.4％),AⅠ型最少(7％).

abstractsObjective To explore the clinical classification of the brachial plexus root injury in adult. Methods All 155 cases of adult brachial plexus root injury in the First Affiliated Hospital of Sun Yat-sen University,were collected and analyzed on their characteristic,operative methods,and clinical outcome so as to find the distribution and incidence of different type of brachial plexus root injury and set up the clinical classification of adult brachial plexus root injury.Results Brachial plexus root injuries in adult could be classified into three types and seven subtypes.Type A is upper brachial plexus root injury,including type AⅠ (C5,C6 completely avulsion or rupture injury,with/without phrenic nerve injury),type AⅡ (C5-C7 completely injury),and type AⅢ (C5-C7 completely injury accompanied with C8,T1 incompletely injury).Type B is lower brachial plexus root injury,including type BⅠ[ C8,T1 (with/without C7)completely injury ] and type BⅡ (C8,T1,C7 completely injury,accompanied with C5、6 incompletely injury).Type C is total brachial plexus root injury,including type CⅠ(C5-T1 completely root avulsion) and type CⅡ(C7-T1 root avulsion accompanied with C5、6 root or trunk rupture).For the cases of every type,u pper brachial plexus root injury type A have 86 cases,in which type AⅠ 6 cases,type AⅡ 27 cases and type AⅢ 53 cases; lower brachial plexus root injury type B have 6 cases,in which type BⅠ 2 cases and type BⅡ 4 cases; total brachial plexus root injury type C have 63 cases,in which type CⅠ 51 cases and type CⅡ 12 cases. Conclusion Except the upper,lower,and total three types,brachial plexus root injuries in adult could be classified further into seven subtypes.The distribution of different type of adult brachial plexus root injury is overbalance:upper type A (55.5％) is more often seen,total type C(40.6％) followed and lower type B(3.9％) is the least seen.In upper brachial plexus root injury,type AⅢ(61.6％) is more often seen,type AⅡ(31.4％) followed and type AⅠ(7％) is less seen.