肘管综合征57例神经电生理分析
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摘要
目的探讨肘管综合征患者的神经电生理特点。方法总结57例肘管综合征患者的神经电生理资料,与38例正常人(76侧肢体)的神经电生理数据进行分析比较。结果病例组尺神经运动传导速度肘上-肘下段为(34.74±9.57)m/s,复合肌肉动作电位潜伏期较对照组延长,波幅降低,差异有统计学意义(P <0.05)。病例组6侧未引出复合肌肉动作电位,31侧未引出感觉神经动作电位。针极肌电图提示第一骨间背侧肌自发电位出现率77.77%(21/27),小指展肌自发电位出现率84.21%(16/19)。结论神经电生理检测为诊断肘管综合征的可靠手段,可准确定位尺神经受损部位及损伤程度。
Objective To investigate the nerve electrophysiological characteristics of patients with cubital tunnel syndrome. Methods Electrophysiological data of 57 patients with cubital tunnel syndrome were collected. And the results were compared with the healthy limbs of 38 healthy people. Results The average conduction velocity of the ulnar nerve decreased, the motor conduction velocity(MCV) from above to below elbow was(34.74±9.57) m/s; the latency and amplitude of compound muscle action potential prolonged and decreased respectively. The difference between the patients group and the healthy control group was statistically significant(P < 0.05). The compound muscle action potential could not be elicited in 6 of the 77 upper limbs, and sensory nerve action potential could not be elicited in 31 of the 77 upper limbs. Electromyography indicated that the spontaneous potential incidence of the first dorsal interosseous muscle was77.77%(21/27), the spontaneous potential incidence of the little finger abductor muscle was 84.21%(16/19). Conclusions Nerve electrophysiological examination could provide the reliable evidence for early diagnosis of cubital tunnel syndrome,and the information for the exact location and degree of the ulnar nerve lesion.
Objective To investigate the nerve electrophysiological characteristics of patients with cubital tunnel syndrome. Methods Electrophysiological data of 57 patients with cubital tunnel syndrome were collected. And the results were compared with the healthy limbs of 38 healthy people. Results The average conduction velocity of the ulnar nerve decreased, the motor conduction velocity(MCV) from above to below elbow was(34.74±9.57) m/s; the latency and amplitude of compound muscle action potential prolonged and decreased respectively. The difference between the patients group and the healthy control group was statistically significant(P < 0.05). The compound muscle action potential could not be elicited in 6 of the 77 upper limbs, and sensory nerve action potential could not be elicited in 31 of the 77 upper limbs. Electromyography indicated that the spontaneous potential incidence of the first dorsal interosseous muscle was77.77%(21/27), the spontaneous potential incidence of the little finger abductor muscle was 84.21%(16/19). Conclusions Nerve electrophysiological examination could provide the reliable evidence for early diagnosis of cubital tunnel syndrome,and the information for the exact location and degree of the ulnar nerve lesion.
引文
[1]张敏健,沈俭,程记伟,等.327例腕管综合征患者的肌电图分析[J].上海医药,2017,8:19-21.
[2]Naran S,Imbriglia JE,Bilonick RA,et al.A demographic analysis of cubital tunnel syndrome[J].Ann Plast Surg,2010,64:177-179.
[3]Feindel W,Stratford J.Cubital tunnel compression in tardy ulnar palsy[J].Can Med Assoc,1958,78:351-353.
[4]Latinovic R,Gulliford MC,Hughes RA.Incidence of common compressive neuropathies in primary care[J].Neurol Neurosurg Psychiatry,2006,77:263-265.
[5]Kong L,Bai J,Yu K,et al.Predictors of surgical outcomes after in situ ulnar nerve decompression for cubital tunnel syndrome[J].Ther Clin Risk Manag,2018,14:69-74.
[6]Polatsch DB,Melone CP Jr,Beldner S,et al.Ulnar nerve anatomy[J].Hand Clin,2007,23:283-289.
[7]卢惠苹,宋林,林盈.肘管综合征的高频超声和神经传导速度的分析研究[J].中华物理医学与康复杂志,2015,37:212-213.
[8]陈冉,阚世廉,李津.以急性加重为表现的肘管综合征临床特征与治疗[J].中华医学杂志,2015,95:3370-3372.
[9]张春晖,刘继,刘喜波.改良筋膜瓣在尺神经松解皮下前置术中的应用[J].北京医学,2018,40:27-29.
[10]刘勇,方有生.肘管综合征的研究进展[J].实用骨科杂志,2015,21:622-626.
[11]Radka N,Oldrich V,Edvard E,et al.The dependence of age on ulnar nerve conductive study parameter adaptation after compressive ulnar neuropathy operations in the elbow[J].Acta Neurochir(Wien),2015,157:1405-1409.
[12]American Association of Electrodiagnostic Medicine,American Academy of Neurology,and American Academy of Physical Medicine and Rehabilitation.Practice parameter:electrodiagnostic studies in ulnar neuropathy at the elbow[J].Neurology,1999,52:688-690.
[13]田东,顾雁浩,张凯莉,等.探讨肘管综合征电生理分期的定量指标[J].中华手外科杂志,2006,22:289-291.
[14]Mukund R.Thatte,compressive neuropathy in the upperlimb.Indian[J].Plast Surg,2011,44:283-297.
[2]Naran S,Imbriglia JE,Bilonick RA,et al.A demographic analysis of cubital tunnel syndrome[J].Ann Plast Surg,2010,64:177-179.
[3]Feindel W,Stratford J.Cubital tunnel compression in tardy ulnar palsy[J].Can Med Assoc,1958,78:351-353.
[4]Latinovic R,Gulliford MC,Hughes RA.Incidence of common compressive neuropathies in primary care[J].Neurol Neurosurg Psychiatry,2006,77:263-265.
[5]Kong L,Bai J,Yu K,et al.Predictors of surgical outcomes after in situ ulnar nerve decompression for cubital tunnel syndrome[J].Ther Clin Risk Manag,2018,14:69-74.
[6]Polatsch DB,Melone CP Jr,Beldner S,et al.Ulnar nerve anatomy[J].Hand Clin,2007,23:283-289.
[7]卢惠苹,宋林,林盈.肘管综合征的高频超声和神经传导速度的分析研究[J].中华物理医学与康复杂志,2015,37:212-213.
[8]陈冉,阚世廉,李津.以急性加重为表现的肘管综合征临床特征与治疗[J].中华医学杂志,2015,95:3370-3372.
[9]张春晖,刘继,刘喜波.改良筋膜瓣在尺神经松解皮下前置术中的应用[J].北京医学,2018,40:27-29.
[10]刘勇,方有生.肘管综合征的研究进展[J].实用骨科杂志,2015,21:622-626.
[11]Radka N,Oldrich V,Edvard E,et al.The dependence of age on ulnar nerve conductive study parameter adaptation after compressive ulnar neuropathy operations in the elbow[J].Acta Neurochir(Wien),2015,157:1405-1409.
[12]American Association of Electrodiagnostic Medicine,American Academy of Neurology,and American Academy of Physical Medicine and Rehabilitation.Practice parameter:electrodiagnostic studies in ulnar neuropathy at the elbow[J].Neurology,1999,52:688-690.
[13]田东,顾雁浩,张凯莉,等.探讨肘管综合征电生理分期的定量指标[J].中华手外科杂志,2006,22:289-291.
[14]Mukund R.Thatte,compressive neuropathy in the upperlimb.Indian[J].Plast Surg,2011,44:283-297.