健侧C7神经移位术治疗中枢性上肢偏瘫的 研究进展

Advances in Contralateral C7 Nerve Transfer for the Treatment of Central Upper Limb Hemiplegia

摘要: 中枢性上肢偏瘫是卒中、脑外伤等中枢损伤后的常见致残表现，多年来，传统康复治疗方式难以帮助患者突破功能瓶颈。健侧C7神经移位术通过重建跨半球神经通路，进一步激发中枢神经重塑，为治疗中枢性上肢偏瘫提供了新路径。本文通过综述其起源、手术原理与操作方式，梳理基础实验与临床研究证据得到结论：该术式可显著改善患者上肢运动功能、缓解痉挛，且并发症多为可逆性，安全性良好。同时指出，目前该术式在靶神经选择、手术时机细化、循证证据等级及术后康复规范等方面仍存不足。未来需通过多中心大样本研究、个体化评估体系构建及标准化康复方案制定等完善其应用，为患者提供更精准的综合治疗。

Abstract: Central upper limb hemiplegia is a common disabling phenotype after central injuries such as stroke and traumatic brain injury, and traditional rehabilitation methods are difficult to break the functional bottleneck in the chronic phase. Contralateral C7 nerve transfer provides a new therapeutic approach by reconstructing cross-hemispheric neural pathways and stimulating central neural remodeling. This review summarizes its origin, surgical principles and operation methods, and combs the evidence from basic experiments and clinical studies: the procedure can significantly improve patients’ upper limb motor function, relieve spasticity, with mostly reversible complications and good safety. Meanwhile, it points out that there are still deficiencies in target nerve selection, refinement of surgical timing, level of evidence-based evidence and standardization of postoperative rehabilitation. Future research should improve its application through multi-center large-sample studies, establishment of individualized evaluation systems and formulation of standardized rehabilitation programs, so as to provide more precise comprehensive treatment for patients.