中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2014年
6期
403-407
,共5页
贾志荣%柳竹%王亭亭%石盺%梁为
賈誌榮%柳竹%王亭亭%石盺%樑為
가지영%류죽%왕정정%석흔%량위
肘管综合征%尺神经%神经传导%电生理学
肘管綜閤徵%呎神經%神經傳導%電生理學
주관종합정%척신경%신경전도%전생이학
Cubital tunnel syndrome%Ulnar nerve%Nerve conduction%Electrophysiology
目的：探讨短节段神经传导检测法（寸进法）在肘管综合征的应用价值。方法分析46例临床确诊为肘管综合征患者的临床及神经电生理检测资料。其中男性32例，女性14例，年龄19～59岁，平均（41.2±12.7）岁。一侧有症状或体征者41例（41肢），其中左侧30肢，右侧11肢；双侧有症状或体征者5例（10肢）。46例患者无症状肢体41肢，共92个肢体。双侧均行长节段分段尺神经运动神经传导及寸进法检测。对30名健康志愿者行双侧寸进法检测，作为正常值对照。结果常规长节段分段运动神经传导异常的有51条尺神经，均为有症状肢体。寸进法检测中，有68条尺神经存在异常，包括51个有症状肢体及17个无症状肢体。髁上2 cm 至髁部节段异常的有41条（44.6％）尺神经，髁部至髁下2 cm节段异常的有23条（25％）尺神经，髁上4 cm至髁上2 cm节段异常的有18条（19.6％）尺神经，髁上6 cm至髁上4 cm节段异常的有9条（9.8％）尺神经，髁下2 cm至髁下4 cm节段异常的有8条（8.6％）尺神经，髁下4 cm至髁下6 cm节段异常的有6条（6.5％）尺神经。各异常率比较发现，肘上2 cm至肘与其他节段均存在差异，有统计学意义（经卡方检验，均P＜0.05）。结论寸进法较常规长节段分段神经传导检测在肘管综合征的诊断中敏感度较高，能发现轻微病变，能精确定位病变部位，在肘管综合征的诊断及定位病变发生部位中都有较高的临床价值。
目的：探討短節段神經傳導檢測法（吋進法）在肘管綜閤徵的應用價值。方法分析46例臨床確診為肘管綜閤徵患者的臨床及神經電生理檢測資料。其中男性32例，女性14例，年齡19～59歲，平均（41.2±12.7）歲。一側有癥狀或體徵者41例（41肢），其中左側30肢，右側11肢；雙側有癥狀或體徵者5例（10肢）。46例患者無癥狀肢體41肢，共92箇肢體。雙側均行長節段分段呎神經運動神經傳導及吋進法檢測。對30名健康誌願者行雙側吋進法檢測，作為正常值對照。結果常規長節段分段運動神經傳導異常的有51條呎神經，均為有癥狀肢體。吋進法檢測中，有68條呎神經存在異常，包括51箇有癥狀肢體及17箇無癥狀肢體。髁上2 cm 至髁部節段異常的有41條（44.6％）呎神經，髁部至髁下2 cm節段異常的有23條（25％）呎神經，髁上4 cm至髁上2 cm節段異常的有18條（19.6％）呎神經，髁上6 cm至髁上4 cm節段異常的有9條（9.8％）呎神經，髁下2 cm至髁下4 cm節段異常的有8條（8.6％）呎神經，髁下4 cm至髁下6 cm節段異常的有6條（6.5％）呎神經。各異常率比較髮現，肘上2 cm至肘與其他節段均存在差異，有統計學意義（經卡方檢驗，均P＜0.05）。結論吋進法較常規長節段分段神經傳導檢測在肘管綜閤徵的診斷中敏感度較高，能髮現輕微病變，能精確定位病變部位，在肘管綜閤徵的診斷及定位病變髮生部位中都有較高的臨床價值。
목적：탐토단절단신경전도검측법（촌진법）재주관종합정적응용개치。방법분석46례림상학진위주관종합정환자적림상급신경전생리검측자료。기중남성32례，녀성14례，년령19～59세，평균（41.2±12.7）세。일측유증상혹체정자41례（41지），기중좌측30지，우측11지；쌍측유증상혹체정자5례（10지）。46례환자무증상지체41지，공92개지체。쌍측균행장절단분단척신경운동신경전도급촌진법검측。대30명건강지원자행쌍측촌진법검측，작위정상치대조。결과상규장절단분단운동신경전도이상적유51조척신경，균위유증상지체。촌진법검측중，유68조척신경존재이상，포괄51개유증상지체급17개무증상지체。과상2 cm 지과부절단이상적유41조（44.6％）척신경，과부지과하2 cm절단이상적유23조（25％）척신경，과상4 cm지과상2 cm절단이상적유18조（19.6％）척신경，과상6 cm지과상4 cm절단이상적유9조（9.8％）척신경，과하2 cm지과하4 cm절단이상적유8조（8.6％）척신경，과하4 cm지과하6 cm절단이상적유6조（6.5％）척신경。각이상솔비교발현，주상2 cm지주여기타절단균존재차이，유통계학의의（경잡방검험，균P＜0.05）。결론촌진법교상규장절단분단신경전도검측재주관종합정적진단중민감도교고，능발현경미병변，능정학정위병변부위，재주관종합정적진단급정위병변발생부위중도유교고적림상개치。
Objective To evaluate the value of the short-segment nerve conduction studies (SSCSs, inching test) in the diagnosis and localization of cubital tunnel syndrome (CubTS).Methods The clinical and electrophysiologic data of 46 patients (92 limbs from 32 men and 14 women, aged from 19 to 59 years, with average age of 41.2 years) with CubTS were collected.The symptoms occurred in unilateral arm in 41 patients and bilateral arms in 5 patients, involving 35 left arms and 16 right arms.SSCSs were performed in both arms in all the 46 patients.Sixty ulnar nerves were studied in 30 healthy control subjects using SSCSs.Results The 51 symptomatic arms with CubTS were abnormal in long segment motor nerve conduction studies.There were 68 abnormal arms ( 51 symptomatic arms, 17 asymptomatic arms ) in SSCSs.The lesions were located 2 cm proximal to the elbow-the elbow segment ( AE2-E ) in 41 arms (44.6%),the elbow-2 cm distal to the elbow segment (E-BE2) in 23 arms (25%), 4 cm proximal to the elbow-2 cm proximal to the elbow segment (AE4-AE2) in 18 arms (19.6%), 6 cm proximal to the elbow-4 cm proximal to the elbow segment (AE6-AE4) in 9 arms (9.8%), 2 cm distal to the elbow-4 cm distal to the elbow segment (BE2-BE4) in 8 arms(8.6%) and 4 cm distal to the elbow-6 cm distal to the elbow segment (BE4-BE6) in 6 arms(6.5%),respectively.Conclusions SSCSs are more sensitive in detecting CubTS than the conventional long segment motor conduction studies.SSCSs could precisely localize the entrapment lesions in patients with CubTS ,might be a useful tool for the detection of ulnar mononeuropathy at the elbow, especially for diagnosing the patients with CubTS who have no clinical features or have a normal long segmental nerve conduction findings.
