| 摘要: |
| ［摘要］ 放射性臂丛神经损伤（RIBRI）是指患者在放射治疗过程中，臂丛神经受高剂量或是单次大剂量照射后引起的臂丛神经功能障碍。发病机制尚不十分明确，放射性纤维化发挥了重要作用。致病因素主要为放射因素、联合治疗、个体差异等，导致患者发病情况不一。RIBRI潜伏期为数月或数年，初期主要表现为上肢主观感觉异常或神经性疼痛，随着病变进展，逐渐发展为整个上肢感觉减退、麻痹无力、甚至瘫痪，神经性疼痛发生较少。该病可以通过患者的放射治疗史、无症状间歇期、临床特点、查体、MRI、肌电图等检查明确诊断，需注意与肿瘤转移或放射诱导性肿瘤相鉴别。RIBRI是一种不可逆性疾病，目前尚无根治方法，重在预防，药物、手术等治疗起到一定缓解作用。 |
| 关键词: 放射性臂丛神经损伤 放射性纤维化 放射治疗 发病机制 |
| DOI：10.3969/j.issn.1674-3806.2014.06.30 |
| 分类号:R 730 |
| 基金项目:广西卫生厅科研课题（编号：Z2013370） |
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| Recent progress on research of radiation-induced brachial plexus injury |
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LIU Xu, LU He-ming
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Graduate School of Guangxi Medical University, Guangxi 530021, China
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| Abstract: |
| ［Abstract］ Radiation-induced brachial plexus injury(RIBPI) is a functional disorder of the brachial plexus(BP), caused by higher total radiation dose or higher single dose to the BP during radiation therapy(RT). The etiology involved in the development of RIBPI includes RT, combined treatment modalities, and individual susceptibility. Its latent may vary largely, from a few months to several years. Initial symptom may be subjective paresthesia or neuropathic pain in the upper extremities. Subsequently, the patients may suffer from hypesthesia in the upper extremities, weakness, or even paralysis. The diagnosis of RIBPI is based on history of RT, interval with no symptom, clinical manifestation, physical exam, magnetic resonance imaging (MRI), and electromyogram. Differential diagnosis should exclude metastasis from malignant disease or radiation-induced second malignance. It is believed that the RIBPI is a progressive process which may eventually result in devastating functional consequences, and no effective modality is available to treat this disease so far. Medication and surgery only play a palliative role in this disease. Therefore, methods for preventing BP injury before its onset appear particularly crucial. |
| Key words: Radiation-induced brachial plexus injury(RIBRI) Radiation-induced fibrosis Radiation therapy(RT) Pathogenesis |
