CAJ | 학술논문

目的：探讨神经电生理检测对诊断腕管综合征（CTS）的临床意义。方法对42例（74侧）CTS 患者正中神经的神经电位、传导速度测定，拇短展肌、小指展肌肌电图（EMG）检查，并与30例（60侧）正常者对比分析。结果42例（74侧）CTS 患者做神经电生理检测，正中神经感觉传导异常100％，其中感觉传导速度（SCV）减慢85．1％，感觉电位潜伏期（DSL）延长89．2％，感觉电位波幅（SNAP）降低24．3％，感觉动作电位未引出4侧；正中神经运动传导异常97．3％，其中运动传导速度（MCV）减慢5．4％，运动末端潜伏期（DML）延长83．8％，运动电位波幅（CMAP）降低20．3％，运动动作电位未引出3侧。CTS 组患者正中神经 SCV、DSL、SNAP、DML、CAMP 与对照组比较，差异有统计意义（P ＜0．05）。CTS 组74块拇短展肌57块（77．0％）呈神经源性损害改变。结论神经电生理检测对早期诊断CTS、确定正中神经的损伤程度具有重要价值，是临床诊断 CTS 的重要手段。
목적：탐토신경전생리검측대진단완관종합정（CTS）적림상의의。방법대42례（74측）CTS 환자정중신경적신경전위、전도속도측정，무단전기、소지전기기전도（EMG）검사，병여30례（60측）정상자대비분석。결과42례（74측）CTS 환자주신경전생리검측，정중신경감각전도이상100％，기중감각전도속도（SCV）감만85．1％，감각전위잠복기（DSL）연장89．2％，감각전위파폭（SNAP）강저24．3％，감각동작전위미인출4측；정중신경운동전도이상97．3％，기중운동전도속도（MCV）감만5．4％，운동말단잠복기（DML）연장83．8％，운동전위파폭（CMAP）강저20．3％，운동동작전위미인출3측。CTS 조환자정중신경 SCV、DSL、SNAP、DML、CAMP 여대조조비교，차이유통계의의（P ＜0．05）。CTS 조74괴무단전기57괴（77．0％）정신경원성손해개변。결론신경전생리검측대조기진단CTS、학정정중신경적손상정도구유중요개치，시림상진단 CTS 적중요수단。
Objective To investigate the value of clinical diagnosis of electrophysiological detection in carpal tunnel syndrome (CTS).Methods The nerve action potential and conduction velocity of median nerve,electromyography (EMG)of abductor pollicis brevis in 42 patients(74 hands)were determined,and the results were analyzed with 30 nor-mal controls(60 hands).Results In 42 cases (74 hands)of patients with CTS witch determined by neural electrophysi-ological detection,the abnormal rate of sensory conduction of median nerve was 100%,in which the rate of sensory con-duction velocity (SCV)slower was 85.1%,distal sensory latency (DSL)delay was 89.2%,sensory nerve action poten-tial (SNAP)decline was 24.3%,the sensory action potentials in 4 hands was not detected;the abnormal rate of motor conduction of median nerve was 97.3%,in which the rate of motor conduction velocity (MCV)slower was 5.4%,distal motor latency (DML)delay was 83.8%,compound muscle action potential (CMAP)decline was 20.3%,the motor ac-tion potential in 3 hands was not detected.Compared with the control group,the SCV,DSL,SNAP,DML,CAMP of median nerve were statistically significant (P<0.05).In CTS group(74 blocks)57 blocks (77%)of abductor pollicis brevis showed neurogenic changes.Conclusion The electrophysiological detection is worthy apllying for early diagnosis of CTS,damage degree determine of median nerve,which is an important tool for clinical diagnosis of CTS.