正中神经节段检查法诊断早期腕管综合征的临床价值

Clinical value of median nerve segments for diagnosing early carpal tunnel syndrome

目的观察神经节段检查法(Inching)诊断早期腕管综合征(CTS)的临床价值。方法对我院2015年6月至2016年6月33例早期CTS患者行正中神经、尺神经常规神经传导检测后,再行Inching检测,同时选择健康体检者30例分别行神经传导检测和Inching检测,比较两组受检者的Inching检测结果。结果 CTS组患者和对照组的SInching检测LD横纹-腕下1 cm[(0.22±0.02)vs(0.17±0.03)ms/cm]、腕下2~3 cm[(0.71±0.14)vs(0.23±0.04)ms/cm]、3~4 cm[(0.74±0.21)vs(0.24±0.05)ms/cm]、4~5 cm[(0.32±0.10)vs(0.21±0.04)ms/cm]值比较,CTS组患者均明显高于对照组,差异均有统计学意义(P<0.05);CTS组患者和对照组的M-Inching检测LD腕下1~2 cm[(0.62±0.11)vs(0.37±0.08)ms/cm]、腕下2~3 cm[(1.32±0.20)vs(0.56±0.10)ms/cm]值比较,CTS组患者均明显高于对照组,差异均有统计学意义(P<0.05);CTS组患者经神经传导检测正中神经感觉传导和正中神经运动传导异常率分别为66.67%(22/33)和60.61%(20/33),敏感性为66.67%;S-Inching和M-Inching检测异常率分别为93.94%(31/33)和87.88%(29/33),敏感性为93.94%,Inching检测法敏感性明显高于神经传导检测,差异有统计学意义(P<0.05)。结论 Inching检测法对早期腕管综合征诊断的敏感度高,且方便、经济、无痛,具有较高的临床应用价值。

Objective To observe the clinical value of median nerve segments test （Inching test） in the diagno- sis of early carpal tunnel syndrome （CTS）. Methods In our hospital from June 2015 to June 2016, 33 patients with early CTS （CTS group） and 30 healthy controls （control group） underwent nerve conduction tests of median nerve, ul- nar nerve, followed by Inching test. The Inching test results were compared between the two groups. Results The LD values of S-Inching test under the horizontal stripes-wrist 1 cm, wrist 2-3 cm, wrist 3-4 cm, wrist 4-5 cm were signifi- cantly higher than those in the control group, （0.22±0.02） ms/era vs （0.17±0.03） ms/cm, （0.71±0.14） ms/cm vs （0.23± 0.04） ms/cm, （0.74±0.21） ms/cm vs （0.24±0.05） ms/cm, （0.32±0.10） ms/cm vs （0.21±0.04） ms/cm, all with P〈0.05. The LD values of M-Inching test under wrist 1-2 era, wrist 2-3 cm were significantly higher than those in the control group, （0.62±0.11） ms/cm vs （0.37±0.08） ms/cm, （1.32±0.20） ms/cm vs （0.56±0.10） ms/cm, all with P〈0.05. The abnormality rate of median nerve sensory conduction and the median nerve motor conduction in nerve conduction test was 66.67% （22/33） and 60.61% （20/33） in CTS group, and the sensitivity was 66.67%. The abnormal rate by S-Inching and M-Inch- ing were 93.94% （31/33） and 87.88% （29/33） respectively, and the sensitivity was 93,94%, which was significantly high- er than 66.67% for nerve conduction test （P〈0.05）. Conclusion Inching test has high sensitivity in the diagnosis of ear- ly CTS, which is convenient, economic, painless, and has high clinical value.