臂丛神经损伤的神经电生理检查  

Electrophysiologic Findings of Newborn Infants with Brachial Plexus Palsy

作　　者：徐娜[1] 曹洁[1] 王莉[1] 钟雪飞[1] 

机构地区：[1]重庆医科大学附属儿童医院神经电生理中心,重庆400014

出　　处：《实用儿科临床杂志》2010年第18期1413-1415,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨神经电生理检测对评价臂丛神经损伤(BPP)的价值。方法对71例BPP患儿(年龄1 d～12个月)进行神经电生理检测,包括神经传导速度(NCV)及肌电图(EMG)检查。NCV测定:测定患儿患侧正中神经、尺神经、桡神经、腋神经的复合肌肉动作电位(CMAP),包括运动神经传导速度(MCV)、远端潜伏期、波幅及F波;测定其患侧相应受检神经的感觉神经传导速度(SCV)。EMG测定:用同心圆针电极记录患侧肱二头肌、三角肌、拇短展肌、小指展肌、指总伸肌的运动单位电位(MUP),观察插入电位、静息时有无失神经电位及轻收缩时MUP的波幅、时程。结果本组最小测定年龄为1 d,已出现NCV及EMG异常;68例行NCV测定,异常63例(92.65%),正中神经、尺神经异常率最高,神经损伤类型有轴索损伤(23.48%)、节段性脱髓鞘(20.45%)、脱髓鞘继发轴索损伤(25.76%)、传导阻滞(30.30%);EMG测定20例,异常16例(80.00%),三角肌、肱二头肌异常率最高;同时测定NCV及EMG 17例,异常16例(94.12%)。结论早期神经电生理检测有助于发现新生儿BPP的潜在病因,并对确定新生儿BPP的类型、部位及程度,对指导早期临床干预和康复治疗具有重要意义。Objective To investigate the value of electrophysiological testing in eveluating the brachial plexus palsy（BPP） in newborn infants.Methods Seventy-one patients with BPP（aged 1 d to 12 months） underwent the electrophysiological investigations,including nerve conduction velocity（NCV）and electromyography（EMG）.NCV：the compound muscle action potential（CMAP） of ipsilateral median nerve,ulnar nerve,radial nerve,and part of the axillary nerve,including motor nerve conduction velocity（MCV）,distal latency,amplitude and F wave were measured.The ipsilateral sensory nerve conduction velocity（SCV） were also determined.EMG：the motor unit potential（MUP） of ipsilateral biceps,deltoid,abductor pollicis brevis,abductor digiti minimi,and extensor digitorum,were recorded by concentric needle electrodes.The observation indexes included insertion potential,spontaneous activity in the resting period,and the amplitudes and duration of MUP during the light muscle contraction.Results The minimum age of this group was 1 day after both,NCV and EMG were abnormal.Sixty-eight cases were examined for NCV,63 cases were abnormity（92.65%）,including axonal injury（23.48%）,demyelination（20.45%）,and se-condary to axonal injury from demyelination（25.76%）,conduction block（30.30%）.The abnormal rates of median nerve and ulnar nerve were the highest.Twenty cases were examined by EMG,16 cases were abnormity（80.00%）.The abnormal rates of deltoid and biceps were the highest.Seventeen cases were examined by NCV and EMG simultaneously,16 cases were abnormity（94.12%）.Conclusions Early electrophysiologic investigations should be performed to detect the potential traumatic cause.It might be of important value in the diagnosis of the property,position and degree of BPP in newborn infant,as well as in the treatment of BPP.

关 键 词：臂丛神经损伤 神经电生理 神经传导速度 肌电图 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]