CAJ | 학술논문

目的探讨针肌电图(EMG)在腰骶神经根压迫性损伤定位诊断中的应用价值,明确其定位诊断的准确性.方法选取腰椎间盘突出症合并神经根压迫的患者198例,所有患者于术前行针EMG检测,并定位存在压迫性损伤的神经根,将所得结果与术中探查所见进行对比.采用神经传导检测(NCS)检查胫神经及腓总神经的运动传导、腓肠及腓浅神经的感觉传导和H反射.结果 EMG对病程在3周以上患者的阳性检测率(90.0％)高于病程在3周以内患者的阳性检测率(21.1％)(P＜0.05).在EMG异常患者中,定位诊断的准确率为92.1％.NCS检查中,46例患者胫神经、52例患者腓总神经的复合肌肉动作电位(CMAP)波幅降低,异常率为49.4％.所有患者胫神经、腓总神经的运动传导速度正常,腓浅神经和腓肠神经的感觉传导正常,其中45例患者H反射消失,33例患者H反射潜伏期较健侧延长1.5 ms以上(P＜0.05).结论 EMG对病程3周以上的腰骶神经根压迫性损伤患者的阳性诊断率高,联合NCS检测对神经根损害有较高的诊断价值,值得临床应用、推广.
목적 탐토침기전도(EMG)재요저신경근압박성손상정위진단중적응용개치,명학기정위진단적준학성.방법 선취요추간반돌출증합병신경근압박적환자198례,소유환자우술전행침EMG검측,병정위존재압박성손상적신경근,장소득결과여술중탐사소견진행대비.채용신경전도검측(NCS)검사경신경급비총신경적운동전도、비장급비천신경적감각전도화H반사.결과 EMG대병정재3주이상환자적양성검측솔(90.0％)고우병정재3주이내환자적양성검측솔(21.1％)(P＜0.05).재EMG이상환자중,정위진단적준학솔위92.1％.NCS검사중,46례환자경신경、52례환자비총신경적복합기육동작전위(CMAP)파폭강저,이상솔위49.4％.소유환자경신경、비총신경적운동전도속도정상,비천신경화비장신경적감각전도정상,기중45례환자H반사소실,33례환자H반사잠복기교건측연장1.5 ms이상(P＜0.05).결론 EMG대병정3주이상적요저신경근압박성손상환자적양성진단솔고,연합NCS검측대신경근손해유교고적진단개치,치득림상응용、추엄.
Objective To evaluate the accuracy of electromyography (EMG) in localizing the compressed nerve root in lumbar intervertebral disc protrusion (LIDP) pre-operatively.Methods Data were collected on 198 cases of LIDP.Of those,152 cases had positive EMG findings and were treated surgically to relieve compression of the nerve roots caused by LIDP.The intra-operative findings were compared with the pre-operative EMG findings.Results The sensitivity of EMG in detecting radiculopathy was 76.8％ (152/198).Among those 152 EMG positive cases,140 were confirmed in the subsequent operation (92.1％),24 clinically suspected cases of single L5 or S1 compression had indicated of both L5 and S1 damage by EMG and subsequently confirmed on surgical exploration.Conclusions Almost all preoperative EMG findings were confirmed in the subsequent operations (92.1％).Moreover,the indication of combined double nerve root damage by EMG was valuable for guiding the surgical procedure.