脊髓栓系综合征的电生理检测特点及临床评价  

The electrophysiological study and clinical evaluation of tethered cord syndrome

作　　者：张丽[1] 陈雨历[1] 李金良[1] 陈维秀[1] 燕凌云[1] 孙大庆[1] 孙小兵[1] 

机构地区：[1]山东大学第二医院小儿外科,济南250033

出　　处：《中华小儿外科杂志》2007年第6期290-293,共4页Chinese Journal of Pediatric Surgery

摘　　要：目的评价脊髓栓系综合征(tethered cord syndrome,TCS)患儿的神经损伤。方法2001年5月～2006年5月对105例TCS患儿行胫神经体感诱发电位(posterior tibial nerve somato- sensory evoked potential study,PTN-SEP)和胫神经、腓总神经运动神经传导(motor conductive veloc- ity,MCV)检测,以及盆底肌肌电图检查。结果TCS患儿皮层电位以及马尾电位潜伏期延长,胭窝处周围电位潜伏期无延长。胫神经MCV异常率34%,58%波幅降低,腓总神经MCV异常率24%,33%波幅降低。盆底肌肌电随着神经损伤程度的加重,由静息状态无自发电位,可见持续收缩电位,小力收缩运动单位电位波幅、时限、多相波升高,大力收缩募集相基本正常,发展到静息状态有自发电位,无或有极少量持续收缩动作电位,小力、大力收缩无动作电位。结论神经电生理检测对判断TCS患儿的神经损害程度及范围,了解预后具有重要的价值。Objective To evaluate the neurological damage in patients with tethered cord syndrome （TCS） by electrophysiological studies. Methods One hundred and five patients with TCS and 25 normal peoples underwent posterior tibial nerve somatosensory evoked potential（PTN-SEP） and motor conductive velocity（MCV） study of the posterior tibial and common peroneal nerves, as well as pelvic floor muscle electromyography from May 2001 to May 2006. Results In patients suffering from TCS, the cortical potential latency （P40） was delayed, even disappeared. The peripheral potential latency （N9） recorded at popliteal region. The abnormal rates of MCV of tibial and common peroneal nerves were 34% and 24%, respectively. The amplitude of tibial nerves and common peroneal nerves was 58% and 33%, respectively. For pelvic floor muscle electromyography, 3 patients had no neurogenie damage. Twelve patients had continuous contraction potential but no spontaneous potential in silent period. In slight voluntary contraction period, amplitude enlarged and duration prolonged markedly. The polyphases waves increased obviously. In maximal voluntary contraction period, recruitment order was normal. Seventeen patients had spontaneous potential and little continuous contraction potential in silent period. In slight voluntary contraction period, amplitude enlarged and duration prolonged markedly. The polyphases waves increased obviously. In maximal voluntary contraction period, recruitment order was mixed pattern. Twenty-three patients had much spontaneous potential in silent period. Continuous contraction potential decreased. In slight voluntary contraction period, amplitude enlarged and duration prolonged markedly. The polyphases waves increased obviously. In maximal voluntary contraction period, action potential decreased obviously and recruitment order was singled pattern. Thirty-six patients had spontaneous potential but no continuous contraction potential in silent period. There was no action potential in slight and maximal volu

关 键 词：脊髓栓系综合征 神经传导 诱发电位 

分 类 号：R744[医药卫生—神经病学与精神病学]