周围神经损伤后功能康复的机制与临床干预 研究进展

Research Progress on the Mechanisms and Clinical Interventions for Functional Rehabilitation after Peripheral Nerve Injury

摘要: 周围神经损伤(PNI)是临床常见疾病，发病率约为1.46%~2.8%，年发病率为0.05%~0.15%，在中国约有30~50万患者，占创伤患者的2.8%。尽管周围神经系统具有再生能力，但轴突再生速度缓慢，且功能恢复率不足60%，临床治疗仍面临巨大挑战。PNI即使经规范治疗，仅有10%~25%的患者能完全恢复受损神经功能，因此此病的致残率仍居高不下。若治疗不及时或方案选择不当，约75%的患者会伴有永久性肢体麻木、运动失控甚至瘫痪，不仅严重影响日常活动能力，更给家庭和社会带来沉重的负担。本文系统综述了近些年周围神经损伤后功能康复的分子机制、细胞机制和中枢重塑机制，以及物理治疗、运动疗法等康复手段，为周围神经损伤的临床康复提供参考。

Abstract: Peripheral nerve injury (PNI) is a common clinical disease with an incidence rate of approximately 1.46%~2.8%, and an annual incidence rate of 0.05%~0.15%. There are approximately 300,000 to 500,000 patients in China, accounting for 2.8% of trauma patients. Despite the regenerative capacity of the peripheral nervous system, axonal regeneration is slow, and the functional recovery rate is less than 60%, posing significant challenges to clinical treatment. Even with standardized treatment, only 10%~25% of patients with PNI can fully recover their impaired nerve function, resulting in a persistently high disability rate. If treatment is not timely or the treatment plan is inappropriate, about 75% of patients will experience permanent limb numbness, loss of motor control, or even paralysis, which not only severely affects their daily activity ability but also imposes a heavy burden on families and society. This article systematically reviews the molecular, cellular, and central nervous system remodeling mechanisms underlying functional recovery after peripheral nerve injury in recent years, as well as rehabilitation methods such as physical therapy and exercise therapy, providing a reference for the clinical rehabilitation of peripheral nerve injury.