电生理定位结合术中神经监测在肘管综合征治疗中的应用

Study on the application of electroneurophysiology position oriented diagnosis and Intraoperative monitoring in the treatment of cubital tunnel syndrome

目的探讨神经电生理定位诊断、术中监测在肘管综合征（CTs）中的应用。方法55名尺神经松解前置术治疗CTs患者，术前用短节段位移法定位病变部位，术中监测尺神经传导速度（NCV）、潜伏期、波幅变化并对卡压组织行病理检查。结果短节段位移法定位正确率83．64％；87．26％卡压组织为透明变性的韧带样组织；卡压组织切除后，NCV增快（t=14．15，P〈0．01），潜伏期缩短（t=-14．10，P〈0．01），波幅变化差异无统计学意义（t=0．114，P〉0．05）；神经外膜切开后各指标变化差异均无统计学意义（P〉0．05）。结论神经电生理短节段位移法可较准确定位CTs病变；神经外膜松解术治疗CTs短期疗效不显著。

Objective Dicussing the application of electroneurophysiology position oriented diagnosis and Intraoperative monitoring in the treatment of cubital tunnel syndrome （CTs）. Methods 55 in- patients with CTs treated by ulnar nerve anterior transposition were enrolled. Intraoperative ulnar nerve conduction velocity（NCV） ,latent period and amplitude were recorded, electroneurophysiology position oriented diagnosis and pathology exam were also used. Results Accuracy rate of entrapment positioning by position oriented diagnosis is 83.64%, most of compressing agents （87.26%） are hyaline degeneration of ligaments ;NCV is increased （t = 14.15 ,P 〈 0.01 ）while latent period is shorten after compressing agent excision（ t = -14.10, P 〈 0.01 ） ;electroneurophysiology indices have no significant change after epineurium dissection （P 〉 0.05 ）. Conclusion Electroneurophysiology position oriented diagnosis can locate the diseased region of CTs;the short term effectiveness of epineurium dissection is not remarkable.