肌骨超声与神经电生理检查联合诊断在肘管综合征术前指导中的意义

Significance of Combination of Musculoskeletal Ultrasound and Neurophysiological Examination for Surgical Indication of Cubital Tunnel Syndrome

目的:分析肌骨超声与神经电生理检查联合诊断在肘管综合征术前指导中的意义。方法:选取2021年1月—2023年1月滨州市中心医院收治的疑似肘管综合征患者100例为研究对象,对所有患者采用肌骨超声、肌骨超声联合神经电生理检查方式进行诊断,分析肌骨超声与神经电生理检查联合诊断在肘管综合征术前指导中的意义(诊断准确率、特异度、敏感度)。结果:以临床病理结果为“金标准”,确诊阳性患者68例,阴性患者32例;肌骨超声诊断敏感度82.35%、特异度81.25%、准确度82.00%;肌骨超声与神经电生理检查联合诊断敏感度98.53%、特异度68.75%、准确度89.00%。联合诊断敏感度高于肌骨超声诊断,差异有统计学意义(P=0.001)。阳性患者侧尺神经横截面积水平高于阴性患者,肘上、肘下感觉神经神经传导速度水平低于阴性患者,差异有统计学意义(P=0.001)。结论:肌骨超声与神经电生理检查联合诊断在肘管综合征术前指导中具有更高的敏感度与特异度,综合应用价值较高。

Objective:To investigate effectiveness of musculoskeletal ultrasound combined with nerve electrophysiology examina⁃tion for surgical indication in patients with cubital tunnel syndrome.Methods:100 patients with suspected cubtial tunnel syn⁃drome admitted to Binzhou Central Hospital from January 2021 to January 2023 were selected as study subjects,and all patients were examined by either myoskeletal ultrasound or by the combination of myoskeletal ultrasound and neuroelectrophysiological ex⁃amination.The following indexes of diagnostic methods were analyzed:accuracy,specificity and sensitivity.Results:Pathological findings work as the diagnostic"gold standard",and 68 patients were diagnosed positively and other 32 patients with negative di⁃agnosis.The sensitivity of musculoskeletal ultrasound diagnosis was 82.35%,the specificity was 81.25%,and the accuracy was 82.00%;the sensitivity of combined diagnosis of musculoskeletal ultrasound and neurophysiological examination was 98.53%,the specificity 68.75%,and the accuracy 89.00%.The combined diagnostic sensitivity of musculoskeletal ultrasound and neurophysi⁃ology was 98.53%,specificity 68.75%and accuracy 89.00%.The sensitivity of combined diagnosis was higher than that of muscu⁃loskeletal ultrasound diagnosis,and the difference was statistically significant(P=0.001).The cross-sectional area of lateral ulna nerve in positive patients was higher than that in negative patients,and sensory nerve conduction velocity above and below the el⁃bow in positive patients was lower than in negative patients,and the difference was statistically significant(P=0.001).Conclusion:The combined diagnosis of musculoskeletal ultrasound and neurophysiologic examination leads to higher diagnostic sensitivity and specificity in patients with cubital tunnel syndrome,and the comprehensive application value is higher.