下肢节段性神经根刺激H反射  

Segmental H-reflex to spinal nerve root stimulation

作　　者：傅鸿翔[1] 吴萍嘉[1] 邵福源[1] 朱愈 

机构地区：[1]第二军医大学长征医院神经内科,海军杭州疗养院康复中心

出　　处：《第二军医大学学报》1996年第3期236-240,共5页Academic Journal of Second Military Medical University

摘　　要：目的：探索理想的诊断腰骶神经根病的神经电生理技术。方法：采用高压短脉冲电刺激技术直接刺激神经根，在比目鱼肌（Ｓ１）及半腱肌（Ｌ５）记录Ｈ反射；共检测正常人３０例、Ｓ１及Ｌ５神经根病２０例，结果：（１）测定了比目鱼肌及半腱肌神经根刺激Ｈ反射（ＮＲＳＨ）正常值。（２）半腱肌和比目鱼肌ＮＲＳＨ在正常人可１００％记录到。（３）Ｌ５Ｓ１椎间隙及Ｓ１神经孔刺激，比目鱼肌及半腱肌ＮＲＳＨ各参数相差均不显著。（４）单纯Ｓ１神经根病仅比目鱼肌ＮＲＳＨ异常，而单纯Ｌ５神经根病仅半腱肌ＮＲＳＨ异常。结论：（ｌ）节段性ＮＲＳＨ记录可靠。（２）感觉及运动神经根椎间孔出口处附近有一低阈值兴奋点。（３）比目鱼肌及半腱肌ＮＲＳＨ具有很好节段特异性。To develop a method of clinical electrodiagnosis of radiculopathy. Methods: Percutaneous high voltage electrical stimulation over the lumbosacral root was used. The H-reflex was recorded from soleus muscle (S_1) and semitendinosus muscle(L_5). 60 normal subjects and 20 cases of S_1 and 20 cases of L_5 radiculopathies were examined. Results: The normal value of H-M interval and its side-to-side difference were detected. Whether the cathodal stimulation was over S1 foramen or L_5S_1 intervertebra, M latency, H latency, H-M interval of soleus and semitendinosus H-reflex were not changed significantly. Both soleus and semitendinosus H-reflex could be recorded in all normal subjects. In S_1 radiculopathies, only soleus H-reflex was abnormal and semitendinosus H-reflex was normal. In L_5 radiculopathies, semitendinosus H-reflex was abnormal and soleus H-reflex was normal. Conclusion: Percutaneous high voltage stimulation of lumbosacral root elicited H-reflex could be recorded reliably. Both sensory and motor nerve fiber has a lower threshold site near its exit site in the vertebral foramina when moderate intensity of electrical stimulation was used. There is high specificity in segmental H-reflex consisting of solues(S_1) and semitendinosus (L_5) H-reflex.

关 键 词：高压电刺激 神经根 H反射 腰骶神经根病 

分 类 号：R745.404[医药卫生—神经病学与精神病学] R338.8[医药卫生—临床医学]