探讨肘管综合征电生理分期的定量指标  

Quantitative parameters of electrophysiologic staging of cubital tunnel syndrome

作　　者：田东[1] 顾雁浩[1] 张凯莉[1] 徐雷[1] 

机构地区：[1]复旦大学附属华山医院手外科肌电图室,上海200040

出　　处：《中华手外科杂志》2006年第5期289-291,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨并制定肘管综合征轻度、中度、重度三期电生理的分期定量指标,为临床分期提供电生理依据。方法对临床诊断为肘管综合征的82例(82侧)患者,测定以下电生理检查：(1)第一背侧骨间肌,小指展肌,尺侧屈腕肌的肌电图(EMG)；(2)肘段尺神经运动神经传导速度(MNCV)的测定；(3)感觉诱发电位的测定(小指→腕,腕→肘)。结果轻度：EMG(-),肘段MNCV≥45．0m/s,尺神经感觉电位或神经于(腕→肘)电位波幅较健侧下降≥50%。中度：EMG(±),肘段MNCV＜45．0m/s,尺神经小指感觉电位波幅及尺神经干电位波幅均较健侧下降＞50%,重度：EMG(+),肘段MNCV＜40．0m/s,复合肌肉动作电位(CMAP)消失,尺神经小指感觉电位或尺神经干的CMAP电位引不出。结论肘管综合征电生理的分期指标,主要看尺神经肘段的MNCV,MNCV≥45．0m/s提示为轻度,MNCV＜45．0m/s提示为中度,MNCV＜40．0m/s提示为重度。Objective To determine the quantitative electrophysiologic parameters of cubital tunnel syndrome （CUTS） of different severity and provide an electrophysiologieal evidence for clinical staging. Methods The following electrophysiologic tests were conducted in 82 patients with clinically diagnosed cubital tunnel syndrome： 1. electromyography （EMG） of the first dorsal interossei, abductor digiti minimi manus muscles, and flexor carpi ulnaris muscles; 2. motor nerve conduction velocity （MNCV） of the ulnar nerve at the elbow; 3. sensory nerve action potentials （SNAP） （little finger-wrist, wrist-elbow）. Results Electrophysiologically cubital tunnel syndrome can be graded as mild, moderate and severe. In mild CuTS the result of EMG is normal, while MNCV is ≥45.0 m/s at the elbow and SNAP amplitude ≥ 50% that of the contralateral side. In moderate CuTS EMG shows susceptive positive results, while MNCV at the elbow is 〈 45.0 m/s and SNAP amplitude 〉 50% that of the healthy side. Positive EMG results are seen in severe CUTS, while MNCV is less than 40.0 m/s at the elbow. Compound muscle action potentials （CMAP） or SNAP in the little finger cannot be induced. Conclusion Electrophysiological staging of cubital tunnel syndrome is mainly dependent on MNCV of ulnar nerve at the elbow. In mild, moderate and severe CUTS, MNCV is ≥45.0 m/s, 〈 45.0 m/s and 〈 40.0 m/s respectively.

关 键 词：肘管综合征 肌电描记术 神经传导速度 

分 类 号：R688[医药卫生—骨科学]