高频超声成像联合神经电生理检测指标对肘管综合征手术切口的指导意义

Guiding significance of high frequency ultrasound imaging technology combined with electrophysiological index in surgery incision of cubital tunnel syndrome

目的探讨高频超声成像技术联合神经电生理检测指标指导肘管综合征手术切口的临床价值。方法选择2013年1月~2015年12月内蒙古医科大学第二附属医院手外科实施手术的213例肘管综合征患者为研究对象,并以患者自身健侧作为对照。手术前进行超声及神经电生理检查,神经电生理检测肘下-肘上段、腕-肘下段运动神经传导速度、感觉神经传导速度;高频超声观察尺神经的连续性、内部结构回声变化、有无局限性膨大及比邻结构关系,测量尺神经膨大处横截面积（CSA）,标注卡压点范围。结果患者患侧CSA及神经电生理神经传导速度与健侧比较,差异均有统计学意义（P〈0.05或P〈0.01）。经手术证实明确卡压部位与体表标记点相差0.5~1.0 cm。结论高频超声成像技术联合神经电生理检查,能够更加精准地确定肘管综合征卡压部位,为临床手术切口的选择提供可靠的引导信息。

Objective To investigating the clinical value of high frequency ultrasound imaging and electrophysiological indicators in guiding of the surgical incision of cubital tunnel syndrome. Methods Two hundred and thirteen patients with cubital tunnel comprehensive syndrome from January 2013 to December 2015 in the Second Affiliated Hospital of Inner Mongolia Medical University were selected as study objects, these patients＇ healthy ulnar nerves were taken as the control. All the patients were tested through high frequency ultrasound and ulnar nerve electrophysiology examination before surgery, motor nerve conduction velocity and sensory nerve conduction velocity of the below-above elbow segment and wrist-below elbow segment were examined. The continuity of ulnar nerve, the change of the echo of internal structure, limitations expand, near structural relationships were observed by high frequency ultrasound, cross-sectional area（CSA） of the expands ulnar nerve was measured, the range of viega profi-press point was labeled. Results CSA and nerve electrophysiology nerve conduction velocity between the diseased side and un-diseased side had statistically significant difference（P〈0.05 or P〈0.01）. There was a difference of 0.5-1.0 cm between the parts confirmed by surgery and skin-marker. Conclusion High frequency ultrasound imaging technology combined with nerve electrophysiological examination can locate cubital tunnel syndrome entrapment sites more accurately, which will provide reliable instructional information for making choice of various surgical operation incisions.