基于高频超声检查的护航官兵尺神经半脱位流行病学研究

Epidemiological study on high-frequency ultrasound diagnosed ulnar nerve subluxation in officers and sailors of an escort mission

目的:研究护航官兵尺神经半脱位高频超声回声表现,提高对尺神经半脱位超声特征的认识,为远海周围神经检查和尺神经半脱位诊断提供超声解剖参照和借鉴。方法:采用随机抽样法从某批护航官兵中选择55例护航官兵进行双侧肘关节屈肘位超声检查,记录尺神经半脱位的发生情况,超声下测量半脱位时尺神经沟的宽度、深度及尺神经位置变化,并与正常位时的上述参数比较。结果:护航官兵尺神经半脱位的发生率为34.55%,其中左肘半脱位为12.73%,右肘半脱位为10.91%,差异无统计学意义(P>0.05)。尺神经半脱位时尺神经沟的宽度为(1.77±0.20)cm,深度为(1.23±0.15)cm,正常位时分别为(1.67±0.16)cm、(1.26±0.12)cm,差异无统计学意义(P>0.05);屈肘时半脱位尺神经位于肱骨内上髁上方或外侧(近心侧),正常位时则位于尺神经沟内靠近肱骨内上髁。结论:护航官兵尺神经半脱位较为常见,高频超声是远海周围神经检查的重要方法;尺神经半脱位与尺神经沟的宽度、深度无关,屈肘后肱骨内上髁可作为尺神经的解剖标识。

Objective To study the high-frequency ultrasound echo views of ulnar nerve subluxation in the officers and sailors of an escort mission,and improve the understanding of the ultrasonic characteristics of ulnar nerve subluxation,so as to provide ultrasonic anatomical reference for the examination of peripheral nerves and the diagnosis of ulnar nerve subluxation for long oceangoing missions.Methods By using random sampling method,55 volunteers were selected from the officers and sailors of a certain batch of escort mission for ultrasonic examination of bilateral elbow joints in elbow flexion,and the occurrence of ulnar nerve subluxation were recorded.The width and depth of sulius for ulnar nerve and position changes of the ulnar nerve in subluxation were measured under ultrasound,and the above data were compared with those in normal position.Results The incidence of ulnar nerve subluxation in the officers and sailors was 34.55%,in which the incidence of left elbow subluxation was 12.73%,and that of right elbow subluxation was 10.91%.There was no significant differences between the two incidences(P>0.05).The width and depth of sulius for ulnar nerve at ulnar nerve subluxation were(1.77±0.20)cm and(1.23±0.15)cm,respectively,compared with(1.67±0.16)cm and(1.26±0.12)cm at normal position.There was no significant difference between them(P>0.05).The subluxated ulnar nerve was located superior or lateral to the medial epicondyle of the humerus(proximal side)when the elbow was flexed,while it was located in the sulius for ulnar nerve and close to the medial epicondyle of the humerus in normal position.Conclusion Ulnar nerve subluxation is common in the officers and sailors of escort missions.High-frequency ultrasound is an important method for peripheral nerve examination for long oceangoing missions.Subluxation of ulnar nerve has no relation with the width and depth of sulius for ulnar nerve.The medial epicondyle of humerus after elbow flexion can be used as an anatomical marker of ulnar nerve.