先天性马蹄内翻足患儿的体感觉诱发电位以及神经电图检测

Somatosensory evoked potentials in patients suffering from congenital clubfoot

目的通过对神经电图以及体感觉诱发电位测定外周向中枢传导的异常并寻找神经病变的位点,探讨先天性马蹄内翻足(CCF)神经电生理异常与马蹄足畸形的关系。方法应用Nicolet公司VikingⅣ肌电图诱发电位仪对手术前的CCF婴幼儿(2000年10月～2003年12月)48例(63个病足)和对照组(9个正常足)进行检测。检测包括下肢胫神经、腓总神经、腓肠神经及H反射。体感觉诱发电位分别于腘窝、腰4、颈7以及头部左右中央进行记录。结果63足中神经电生理异常的有48足(76．2%)。体感觉诱发电位检测显示39个病足(61．9%)存在异常,其中腰_4以下异常24足,神经电图检测显示34个病足结果异常(54．0%),H反射异常20足(31．7%)。三度畸形22足全部存在神经电生理异常,二度畸形39足中26足存在异常。结论76．2%先天性马蹄足患儿存在不同类型及不同程度的神经电生理异常,此异常多存在于脊髓腰4以下节段。通过体感觉诱发电位和神经电图检测显示,神经电生理异常与CCF畸形严重程度相关。

Objective To assess the neural abnormality in patients with congenital clubfoot with somatosenoty evoked potentials （SSEPs）. Methods Forty-eight patients （63 clubfeet） were studied. The results of 39 clubfeet （61.9%） had abnormal SSEPs test results. Results 48 clubfeet （76. 2%） had abnormal neural-electrophysiology, of which a total 39 clubfoots had abnormal SSEP （61.9%）. The neural abnormality correlates with the relative to the degree of the clubfoot deformity. All grade Ⅲ clubfoots showed neural abnormalities, while only 26 out of 39 grade Ⅱ clubfoots were abnormal. Conclusions The result shows that most congenital clubfoots have neural abnormality and the extent of neural abnormality is proportional to the degree of the clubfoot deformity.