肘管综合征患者伸肘与屈肘状态下尺神经运动神经传导速度对比研究

A comparative study of motor nerve conduction velocity of ulnar nerve between elbow extension and elbow flexion in patients with cubital tunnel syndrome

目的对比肘管综合征患者肘关节自然伸直与极度屈曲2min肘管处尺神经的运动神经传导速度(motor nerve conduction velocity,MNCV),探究肘管综合征患者肘管段尺神经MNCV与肘关节屈伸状态的关系。方法在肘关节自然伸直和极度屈曲2min两种不同状态下,对45例确诊的肘管综合征患者用两种方法,即记录电极在小指展肌与第一背侧骨间肌记录,测定肘管段尺神经MNCV.记录电极在小指展肌时,伸肘时的肘管段尺神经MNCV记为V1,屈肘2min的MNCV记为V2;记录电极在第一背侧骨间肌时,伸肘时的MNCV记为V3,屈肘2min的MNCV记为V4。V1与V2,V3与V4,V1与V3,V2与V4分别做配对t检验。结果本组45例患者不同状态下测得的肘管段尺神经MNCV分别为V1(29.47±8.37)m/s、V2(28.32±7.85)m/s、V3(27.91±9.62)m/s、V4(26.76±8.58)m/s.V1与V2,V3与V4,V1与V3,V2与V4配对t检验得出差异均无统计学意义(P>0.05).结论肘管综合征患者肘关节伸直与屈曲状态下肘管段尺神经MNCV无明显差别,记录电极在小指展肌与第一背侧骨间肌检测结果无差异,说明肘管综合征患者行肌电图检测时,屈肘或伸肘状态对检测结果无明显影响。

Objective To compare the motor nerve conduction velocity (MNCV) of ulnar nerve between elbow joint natural extension and extreme flexion for 2 minutes in patients with cubital tunnel syndrome, and to explore the relationship between MNCV of ulnar nerve and elbow joint flexion and extension in patients with cubital tunnel syndrome. Methods Under two different conditions of elbow joint natural extension and extreme flexion for 2 minutes, 45 patients with cubital tunnel syndrome were examined by two methods: recording electrodes in the abductor digitorum minimi and the first dorsal interosseous muscle, and measuring the MNCV of ulnar nerve in the elbow tunnel segment. The MNCV of ulnar nerve was V1 at elbow extension and V2 at elbow flexion for 2 minutes when recording electrodes were in the abductor digitorum minimi;the MNCV of ulnar nerve was V3 at elbow extension and V4 at elbow flexion for 2 minutes when recording electrodes were in the first dorsal interosseous muscle. Matched-pair "tests were performed for V1 and V2, V3 and V4, V1 and V3, V2 and V4, respectively. Results The MNCV of ulnar nerve in the elbow tunnel segment in the 45 patients were V1(29.47±8.37) m/s、V2(28.32±7.85) m/s、V3(27.91±9.62) m/s、 V4(26.7fe:8.58) m/s, respectively. There was no significant difference in paired t test between V1 and V2, V3 and V4, V1 and V3, V2 and V4 (P>0.05). Conclusion There was no significant difference in MNCV of ulnar nerve in elbow segment between elbow joint extension and flexion in patients with cubital tunnel syndrome. There was no significant difference in the results of electromyogram between abductor digitorum minimi and first dorsal interosseous muscle. The results showed that elbow flexion or elbow extension had no significant effect on the results of electromyography in patients with cubital tunnel syndrome.