电生理联合高频超声检查在上臂桡神经炎诊治中的应用

Application of Electrophysiology Tests Combined High-frequency Ultrasound in the Diagnosis and Treatment of the Upper-arm Radial Neuritis

目的：探讨电生理联合高频超声检查在上臂桡神经炎诊治中的意义。方法：分析西京医院手外科自2010年12月至2015年7月收治的14例诊断为上臂桡神经炎的患者,男8例,女6例;年龄21~33岁,平均24.6岁;病程2周~1.8年。所有患者进行电生理检查、高频超声检查,确诊后行外科手术治疗及病理检查。结果：电生理检查：2例明确诊断为外侧肌间隔处桡神经完全损伤;5例诊断为外侧肌间隔处桡神经严重损伤;6例诊断为外侧肌间隔处桡神经中度损伤;1外侧肌间隔处可能损伤,由于病史小于3周,建议随访。高频超声检查：6例为I型,神经长段均匀肿胀,回声减低;8例为II型神经一处或多处缩窄,缩窄两端肿胀,回声减低,呈漏沙或腊肠样变。其中II型中有一例呈局部多处缩窄。本组患者经手术探查及术后病理证实两者联合检查诊断率可达100%。结论：电生理联合超声检查,可提高上臂桡神经炎的诊断率。

Objective： Investigate the significance of electrophysiology tests combined high-frequency ultrasound in the diagnosis and treatment of the upper-arm radial neuritis. Methods： Analyze 14 patients we, the Hand Surgery Department of Xijing Hospital, admitted, from December 2010 to July 2015, who were diagnosed as the upper-arm radial neuritis, including 8 males and 6 females. The age ranges from 21 to 33 years old and the mean age is 24.6. The course of the disease ranges from 2 weeks to 1.8 years. Electrophysiological tests and high-frequency ultrasound were all used on each patient. Aider a definite diagnosis, operations and pathological examinations were performed. Results： Electrophysiological examination results： 2 cases were diagnosed as complete radial nerve injury in the lateral intermuscular septum; 5 cases were severe radial nerve injury in the lateral intermuscular septum; 6 cases were moderate radial nerve injury in the lateral intermuscular septum; 1 case was diagnosed as possible injury in the lateral intermuscular septum, which was recommened follow-up visits because the medical history was less than 3 weeks. High frequency ultrasonography results： 6 cases were type I nerve even swelling, hypoechoic; the other 8 cases had one or more constrictions in the type H nerve, narrow at both ends of the swelling, hypocchoic, with a drain sand or sausage like change. Among the type II nerve injury, there was one case having a local multiple constriction. Patients in this group proved the diagnosis rate was 100% after the surgical exploration and operation. Conclusion： Electrophysiology test combined high-frequency ultrasound can improve the diagnostic rate of the upper-arm radial neuritis.