高压电烧伤后周围神经损害的调查研究

Investigative study of peripheral nerve injury after high voltage electric burn

目的探讨高压电烧伤病例周围神经的损害情况。方法采用回顾性研究,收集2012-01—2016-10因"高压电烧伤"入我院治疗的病例资料,所有患者均接受过神经传导测试(NCSs),收集受伤侧及正常侧数据并进行分析。结果 30例患者(42侧肢体)纳入研究,其中56.7%的患者从事电工维修职业,其余主要为意外触电所致。52.5%的患者正中神经至少出现一项参数异常;44.7%的患者出现尺神经的异常,未发现脱髓鞘的证据;12例患者行正常侧的NCSs检测,复合肌肉动作电位及神经传导速度显著高于患侧(P<0.05);25例随访显示复合肌肉动作电位及神经传导速度均显著改善(P<0.05)。结论高压电烧伤后主要造成患者的周围神经损害而非脱髓鞘病变。虽伤后NCSs检测结果正常,患者仍可能存在外周神经损害;对侧肢体的对照及后续的随访对于周围神经损害的确切评价具有重要意义。

Objective To explore the peripheral nerve damage of high-voltage electric burn cases. Methods A retrospective study on high-voltage electric burn in our hospital from January 2012 to October 2016 was made. All patients received the nerve conduction test （NCSs） ,the data of injured side and normal side data were collected and comparatively analyzed. Results 30 pa- tients （42 limbs） were included in the study, 56.7% of the patients were engaged in electrical maintenance, and the rest were mainly caused by accidental electric shock. In 52.5 % patients the median nerve at least one parameter;44.7 %of the patients had abnormal ulnar nerve demyelination;no evidence was found; the patients were tested for normal side NCSs in 12 cases, potential and nerve conduction velocity of compound muscle action was significantly higher than that of the affected side （P〈0.05） ;25 pa- tients had follow-up data display with potential and nerve conduction velocity of muscle movements were significantly improved （P〈0.05）. Conclusion High-voltage electrical injury mainly be caused by peripheral nerve damage in patients with non-demye- linating lesions;although NCSs after injury results are normal, patients may still exist in peripheral nerve damage;the exact evalua- tion of the control on the side of the body and the follow-up for peripheral nerve injury has important significance.