26例臂丛神经损伤的神经肌电图分析(英文)

The Analysis of Electroneuromyography in 26 Cases with Brachial Plexus Injuries

目的 :探讨神经肌电图在臂丛受损诊断及定位中的作用。方法 :对 2 6例臂丛受损者采用表面电极法沿神经走行的不同部位顺向检测正中神经、尺神经、桡神经、肌皮神经、腋神经共 91条神经的感觉及运动传导速度 (或末端潜伏期 )、F波 ;并用同心圆针电极观察拇短展肌、小指展肌、指总伸肌、肱二头肌、三角肌、冈上肌、冈下肌共 114块肌肉的病理自发电位及募集形式。结果 :91条运动神经在不同节段收集共有 6 4条异常 (70 3% ) ;6 0条感觉神经有 40条异常 (6 6 7% ) ;2 6例中F波异常者 8例 (30 8% )。检测 114块肌肉 ,其中 5 9块肌肉静息状态出现≥两处纤颤和 (或 )正锐波 ; 49块肌肉重收缩时无运动单位电位 ,9块肌肉募集电位明显减小。结论 :神经肌电图在臂丛神经损伤的诊断及定位中具有重要作用。

Objective:To investigate the significance of electroneuromyography in localization and clinical diagnosis of brachial plexus injuries. Methods: Othodromic surface stimulation and recording were used for nerve conduction studies . The motor and sensory conduction velocity were recoreded in different segments of 91 nerves including median,ulnar, radial, musculocutaneous and axillary nerves.F wave latencies of the median nerves were obtained too. The standard concentric needle electromyography examination was performed on total 114 muscles containing abductor pollicis brevis, abductor digiti minimi, extensor digitorum,biceps brachii,deltoid, supraspinatus and infraspinatus. The pathological spontaneous electric activities and the pattern of motor unit recruitment were observed .Results: Abnormalities were noted in 64 out of 91 motor nerves(70 3% )and in 40 out of 60 sensory nerves (66 7%). Eight out of 26 F-wave latencies prolonged(30 8%). At least two localization fibrillation potentials and/or positive sharp waves occured in 59 out of 114 resting muscles .The motor unit active potentials disappeared during maximal voluntary contraction in 49 muscles and the recruitments decreased in 9 muscles.Conclusion:Electroneuromyography has been very helpful in localizing the lesions and confirming the diagnosis of brachial plexus injuries.