肌电图检查在儿童瘫痪诊断中的临床意义

Clinical significance of electromyogram examination in the diagnosis of paralysis in children

目的 探究与分析肌电图检查在儿童瘫痪中的诊断价值。方法 选取我院2012年7月~2014年7月收治的350例瘫痪患儿作为临床研究对象,对该组患儿行肌电图检查,检查项目包括周围神经传导速度、针极肌电图与重复频率刺激,对于其中18例进行了重复神经电刺激检查,并对检查结果进行记录与分析。结果 肌电图检查结果为肌源性损害41例,其中确诊进行性肌营养不良18例（43.90%）、多发性肌炎3例（7.32%）、诊断不明20例（48.73%）;肌电图检查结果为神经源性损害45例,其中确诊脊髓性肌萎缩2例（4.44%）,急性脊髓炎28例（62.22%）,脊髓灰质炎样综合征7例（15.56%）,诊断不明8例（17.78%）;肌电图检查结果为神经性损害67例,其中确诊注射性神经损害4例（5.97%）,臂丛神经损伤22例（32.84%）,外伤性桡神经损伤24例（35.82%）,格林巴利综合征9例（13.43%）,遗传性运动感觉神经6例（89.55%）,慢性炎性髓鞘性多神经病2例（2.99%）,诊断不明15例（22.39%）;肌电图检查结果为重复刺激异常4例,其中确诊为进行性肌营养不良1例（25.00%）,多发性肌炎1例（25.00%）,诊断不明25例（50.00%）;肌电图检查正常180例,其中确诊为格林巴利综合征2例（11.11%）,脑瘫7例（3.89%）,诊断不明148例（82.22%）。结论 对于肌肉病变及脊髓前角引起的瘫痪行肌电图检查具有重要的临床意义,对于周围神经损害所引起的瘫痪进行定位、鉴别诊断及分型等具有突出应用价值,在对重度肌无力患儿行重复电刺激检查时常显示出较低的阳性率。

Objective To study and analyze the diagnostic value of electromyogram examination of paralysis in children. Methods 350 children with paralysis, who were received and cured in our hospital from July 2012 to July 2014, were selected as clinical research objects, were inspected with the electromyogram examination of peripheral nerve conduction velocity, needle electromyography, and repetitive nerve stimulation, while 18 cases of children were inspected with repetitive nerve stimulation. To record and analyze the examination results. Results The results of electromyogram examination showed that, there were 41 cases of myogenic damage, with progressive muscular dystrophy in 18（43.90%）cases, polymyositis in 3（7.32%）cases, while uncertain diagnosis in 20（48.73%）cases, there were 45 cases of neurogenic damage, with spinal muscular atrophy in 2（4.44%）cases, acute myelitis in 28（62.22%） cases, poliomyelitis-like syndrome in 7（15.56%）cases, while uncertain diagnosis in 8（17.78%）cases, there were 67 cases of nerval damage, with nerve injury caused by injection in 4（5.97%）cases, brachial plexus injury in 22（32.84%） cases, traumatic radial nerve damage in 24（35.82%）cases, guillain-barre syndrome in 9（13.43%）cases, hereditary kinaesthesia nerve in 6（89.55%）cases,chronic inflammatory demyelinating polyradicuroneuropathy in 2（2.99%）cases, while uncertain diagnosis in 15（22.39%）cases, there were 4 cases of abnormal repetitive stimulation, with progressive muscular dystrophy in 1（25.00%）case, polymyositis in l（25.00%）case, while uncertain diagnosis in 25（50.00%） cases, there were 180 cases of normal electromyogram examination, with guillain-barre syndrome in 2（11.1 l%）cases, cerebral palsy in 7（3.89%）cases, while uncertain diagnosis in 148（82.22%）cases. Conclusion Electromyogram examination has significant significance in paralysis which is caused by muscle changes and spinal cord anterior horn, has prominent application value on location, differential diagnosis, and classification etc. in paralysis which is caused by peripheral nerve damage. Electromyogram examination show that repetitive nerve stimulation of children with myasthenia gravis has lower positive rate.