目的 回顾性分析对比残根与各组动力源神经修复上臂丛的临床效果，明确臂丛损伤后残根的可利用性及其临床利用的有效性与合理性。 方法 回顾性分析2007年1月至2015年12月间中山大学附属第一医院入院诊断为部分或全臂丛损伤患者的资料，病例资料收集的内容包括住院号、年龄、性别、诊断、伤因、受伤到手术间隔时间、随访时间、损伤分型、术式、供受体神经间隙、移植物类型及长度、并发症，检查供区不良事件，采用英国医学研究委员会（British Medical Research Council， BMRC）肌力评价标准对患肢三角肌、肱二头肌肌力进行评估，并进行DASH（disabilities of arm， shoulder and hand）评分。 结果 总共136患者接受上臂丛修复术，排除24例，纳入112例。将患者分为4组即：改良Oberlin组22例、CC7+神桥组45例、CC7+直接缝合组27例、残根组14例，残根组中撕脱伤10例，刀刺伤4例。4组三角肌肌力有效率分别为68.2%、71.2%、88.9%和78.6%；肱二头肌肌力有效率分别为81.8%、60.0%、85.2%和64.3%。亚组分析：（1）上臂丛损伤术式比较：残根组4例，均为刀刺伤；改良Oberlin组22例，均为撕脱伤。结果显示两组肩肘关节活动度、三角肌肌力、肱二头肌肌力和DASH评分结果差异无统计学意义；（2）C5-C8或全臂丛损伤术式比较：肩关节活动度残根组与CC7+直接缝合组差异无统计学意义；肘关节屈曲角度、肱二头肌肌力和DASH评分CC7+直接缝合组相比其他两组更为优异，CC7+神桥组次之，残根组再次之（P < 0.05）。 结论 通过对各种类型动力源神经修复上臂丛临床效果进行评估对比分析，明确了残根的可利用性及其临床利用的有效性和合理性，在未来的临床工作中，保护残根可能会提升残根利用的临床疗效和增加动力源神经资源。

Objective To analyze and compare the clinical effects of upper brachial plexus repair with nerve root stumps and each type of power source nerves， determine the availability of nerve root stumps and the effectiveness and rationality of clinical use. Methods Retrospective analysis was performed for the patients admitted to our department from January 2007 to December 2015. The patients were diagnosed with partial or total brachial plexus injury. Case data were collected including gender， age，diagnosis， cause of injury， interval between injury and operation， follow-up time， injury type， operation method， gap length between donor and recipient nerve， graft type and length， and complications. In addition， we also examine the adverse events in the donor site. The British Medical Research Council （BMRC） muscle strength evaluation criteria were used to evaluate the patients' deltoid muscle and biceps muscle strength and we also performed disabilities of arm， shoulder and hand （DASH） score. Results A total of 136 patients received brachial plexus repair， 112 cases included in the study after 24 cases were excluded. The patients were divided into four groups： 22 cases in modified Oberlin surgery group， 45 cases in CC7 transfer comebined with huamn acellular nerve allograft group， 27 cases in CC7 transfer and direct suture group. There were 14 cases of nerve root stumps repair upper trunk directly or combined with huamn acellular nerve allografting， which including 10 cases of BPAI and 4 cases of stab wound. The effective rate of deltoid muscle strength was 68.2%， 71.2%， 88.9% and 78.6%， respectively. The muscle strength and effective rate of biceps were 81.8%， 60.0%， 85.2% and 64.3%， respectively. Subgroup analysis： （1） operative methods for upper brachial plexus injuries： 4 cases with stab wounds in the nerve root stump repair group； in the modified Oberlin surgery group， 22 cases were avulsion injury. The results showed that there were no statistically significant differences between the two groups in the ROM， deltoid muscle strength， biceps muscle strength and DASH score. For the comparison of C5-C8 or TBAI： there is no statistical difference in ROM of shoulder abduction between the nerve root stump repair group and CC7 transfer and direct suture group； the evaluation indexes include angle of elbow flexion， biceps muscle strength and DASH score in CC7 transfer and direct suture group were better than the other two groups， followed by CC7 transfer combined with shenqiao group and nerve root stump repair group. Conclusions This part evaluated and analyzed the clinical effects of various kinds of power sources nerve on the recovery of elbow flexion and shoulder abduction after upper brachial plexus repairing， and determined the availability of nerve root stump and the validity and rationality of its clinical use. Protecting the nerve stump roots may improve the clinical effect of nerve stump utilization and increase the power source nerve in the future.