臂丛根性损伤两种神经电图-肌电图检测方法的诊断符合率  

Combined application of multiple electrophysiological examinations for diagnosis of root injuries of the brachial plexus

作　　者：沈丽英[1] 马建军[1] 顾玉东[1] 陈正永[1] 张凯丽[1] 朱艺 

机构地区：[1]上海医科大学华山医院手外科

出　　处：《中华手外科杂志》1998年第4期215-217,共3页Chinese Journal of Hand Surgery

基　　金：美国中华医学基金;上海市医学领先学科基金;国家自然科学基金;卫生部重点学科基金

摘　　要：目的比较两种神经电图－肌电图检测方法对臂丛根性损伤的诊断符合率。方法１９９７年前，对８２例臂丛根性损伤用上肢五大神经代表肌肉及肩胛带肌群肌电图（ＥＭＧ）、复合肌肉动作电位（ＣＭＡＰ）、运动神经传导速度（ＭＮＣＶ）、感觉神经诱发电位和传导速度（ＳＮＡＰ、ＳＮＣＶ）及体感诱发电位（ＳＥＰ）进行分析诊断。１９９７年起，对１１８例臂丛根性损伤加测颈椎旁肌ＥＭＧ、双侧膈肌的ＣＭＡＰ和斜方肌的ＥＭＧ、ＣＭＡＰ进行诊断。结果１９９７年至今，臂丛根性损伤神经电图－肌电图的诊断和术中发现相比，诊断完全符合率为８０％，完全及基本符合率为９５．４％，比１９９７年前分别提高１４．１％和１０．３％。结论臂丛神经根性损伤加测椎旁肌ＥＭＧ、膈神经、副神经肌电可提高臂丛根性损伤尤其是Ｃ５节后损伤的肌电诊断正确率。Objective To investigate the value of combined use of multiple electrophysiological examinations in the diagnosis of brachial plexus root injuries. Methods 200 cases of brachial plexus root injuries were reviewed about the preoperative electrophysiologic diagnosis and the surgical findings. 82 cases were treated before 1997. Preoperative examinations included electromyogram(EMG), compound muscle action potential(CMAP) of the muscles of shoulder girdle and the representing muscles of the five major nerves in the upper extremity, motor nerve conducting velocity(MNCV), sensory nerve action potential(SNAP), sensory nerve conducting velocity(SNCV), and somatosensory evoked potential(SEP). EMG of cervical paraspinal muscles, CMAP of bilateral diaphragms, and EMG and CMAP of trapezius muscle were also tested in addition to the above mentioned examinations for the 118 cases treated since 1997. Results According to intraoperative exploration, the completely correct diagnostic rate of electrophysiologic examination was 80Electrophysiologic examination of cervical paraspinal muscles and the functional assessment of phrenic nerve and accessory nerve could raise the diagnostic rate of brachial plexus root injuries, in particular postganglionic lesion of C 5 nerve root.

关 键 词：肌电描记术 臂丛神经损伤 脊神经根 电诊断 损伤 

分 类 号：R651.304[医药卫生—外科学]