超声检查在肘管综合征诊治中的应用

The application of ultrasonography in the diagnosis and treatment of cubital tunnel syndrome

目的探讨超声检查在诊断和治疗肘管综合征中的临床意义。方法对34例临床及肌电图检测确诊为肘管综合征的患者,分轻、中、重度三期,应用B超进行检测,与30例(60侧)健康人肘管B超检查结果进行对比研究;同时将B超发现的形态学异常表现与术中所见进行对比研究。结果B超检查显示肘管综合征患者尺神经横截面积,尺神经厚度,尺神经横截面积肿胀率,尺神经厚度肿胀率平均值均大于对照组;随着临床症状逐渐加重,尺神经横截面积肿胀率增大,而尺神经肘段运动传导速度减慢。同时B超发现的形态学异常表现,与术中所见一致。结论B超检查对肘管综合征的诊断、尺神经病变程度的分期,以及治疗方式的选择均有参考价值,为临床提供了一种简单、可靠、无创的检测方法。

Objective To investigate the application of ultrasonography as a tool for diagnosis and treatment of cubital tunnel syndrome. Methods Thirty-four patients who were diagnosed of cubital tunnel syndrome by clinical symptoms and signs and electrophysiological test were involved in the study. They were graded as mild, moderate and severe according to the clinical and electrophysiological findings. Ultrasonography of the elbow was done. Elbows of 60 healthy individuals were also scanned to serve as control. Ultrasonograghic findings were compared to intraoperative findings to verify the accuracy and sensitivity of the test. Results Ultrasonography showed that the cross-sectional area and thickness of the ulnar nerve, as well as its tumefaction ratio were higher in patients of cubital tunnel syndrome than in healthy individuals. The more serious the clinical problem, the higher the tumefaction ratio and slower the motor nerve conduction velocity of ulnar nerve at the elbow. The abnormalities seen in ultrasound agreed with intraoperative findings. Conclusion Ultrasonography provides useful information regarding diagnosis of cubital tunnel syndrome, severity of the disease, and treatment decision making. It should be considered as a convenient, reliable and non-invasive method for the diagnosis of eubital tunnel syndrome.