腕管综合征的电生理诊断

Electrodiagnosis of carpal tunnel syndrome

目的 探讨腕管综合征的电生理诊断方法及其对临床治疗的指导意义。方法 对 72例临床诊断为腕管综合征患者 ,行肌电图 (MEG)、手内肌末梢潜伏期 (DML)、正中神经感觉动作电位 (SNAP)和感觉传导速度 (SNCV)测定 ,并作双侧对比。结果 72例腕管综合征患者 ,6 6例 (91.6 % )正中神经腕以下SNAP消失或波幅大幅衰减 ;5 7例 (79.1% )正中神经腕以下SNCV较健侧或正常值减慢 ;4 8例 (6 6 .7% )拇短展肌末梢潜伏期 (DML)大于 4 .5ms;33例 (4 5 .8% )大鱼际肌可见失神经电位 ,募集反应减弱。结论 电生理检测能灵敏诊断腕管综合征 ,其灵敏性依次为 :正中神经指到腕SNAP波幅衰减 ,SNCV减慢 ,拇短展肌DML延长 ,大鱼际肌失神经改变。

Objective: To explore the electrophysiological diadynamic method of carpal tunnel syndrome, and utilizing it to direct therapy.Methods:For 72 pou patiens of carpal tunnel syndrome, Measuring MEG, DML, SNAP and SNCV, comparison of two sides. Results:To 72 pou patiens of carpal tunnel syndrome, the 66 cases (91.6%) , SNAP is effacement or amplitude of wave attenuating at median nerve wrist below; the 57 cases (79. 1%), SNCV is reduce slow than uninjured side or normal value at median nerve wrist below; the 48 cases (66.7%) DML>4.5 ms; the 33 cases (45.8%), Maximus thenar muscles be found miss nerve potential and recruitment to weaken.Conclusions: The detect of electrodiagnasis can sensitive diagnose carpal tunnel syndrome, susceptiveness one by one: SNAP amplitude of wave of digit to wrist of median nerve attenuating, SNCV of digit to wrist of median nerve reducing slow, DML of abductor pollicis brevis muscle elongating, Maximus thenar muscles be found miss nerve potential.