神经肌电图检查对足下垂患者病因诊断的回顾性分析

RETROSPECTIVE ANALYSIS OF ELECTRONEUROMYOGRAPHY FOR ETIOLOGICAL DIAGNOSIS IN PATIENTS WITH FOOT DROP

目的:通过神经肌电图检查对足下垂患者的临床资料、发病特点、病因诊断进行回顾性分析,为以后临床诊断、治疗提供依据。方法:收集我院2016年9月至2018年1月门诊无明显外伤的足下垂患者20例,对患侧下肢行神经及相关肌肉检测,通过所得数据分析足下垂患者患病原因。结果:7例诊断为腓总神经病,其中4例以腓骨小头上-下段传导速度减慢、动作电位波幅下降超过50%,为不良姿势、体位导致,3例为局部肿物压迫导致腓骨小头处卡压;7例以腓骨长肌、胫后肌、臀中肌、腰椎旁肌肌神经源性损害为主,诊断为腰5神经根病;6例为腓总神经、胫神经动作电位波幅下降,腓骨长肌、股二头肌长头神经源性损害,臀中肌、腰椎旁肌肌电图未见异常,诊断为坐骨神经病。结论:神经肌电图检查在足下垂患者的病因诊断中具有重要临床意义。

Objective： The clinical data, morbidity characteristic and etiological diagnosis of patients with foot drop were analyzed by electroneuromyography to provide the basis for clinical diagnosis and treatment. Methods： Twenty patients of foot drop without obvious trauma in Luoyang Orthopedic Hospital of Henan Province from September 2016 to January 2018 were collected, and the nerve and related muscle of the affected side of the lower extremities were detected, and the cause of the disease was analyzed by the data from electroneuromyography. Results： Seven cases were diagnosed as disease of common peroneal nerve. Among them, 4 cases showed slow conduction velocity in the upper and lower segment of the fibulae capitulum, and the amplitude of action potential decreased more than 50%, which was caused by bad posture and body position. Among them, 3 cases showed the pressure of the fibulae capitulum due to local mass compression. Seven cases were diagnosed as lumbar 5 radiculopathy with neurogenic lesions of peroneus longus, tibialis posterior, mesoglutaeus and paralumbar muscles. Six cases were diagnosed as sciatic nerve disease, showing that the amplitude of the action potential of the common peroneal nerve and the tibial nerve decreased, musculi peronaeus longus and caput longum musculi bicipitis femoris showed neurogenic damage, and no abnormalities were found in the paraspinal muscle. Conclusion： Electroneuromyography has important clinical significance in the etiological diagnosis for patients with foot drop.