卡压性神经病电生理特点分析  

An analysis of the electrophysiological characteristics of entrapment neuropathy

作　　者：白亮[1] 黄华品[1] 林际岚[1] 车春晖[1] 陈圣根[1] 江芳[1] 

机构地区：[1]福建医科大学附属协和医院神经内科,福州350001

出　　处：《中华物理医学与康复杂志》2012年第3期197-200,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：基金项目：福建医科大学专项科研基金（20108007）

摘　　要：目的研究卡压性神经病腕管综合征（CTS）和CTS合并神经根型颈椎病（CSR）的电生理特点，探讨单卡压和双卡压对神经的影响差异。方法对CTS患者81例和CTS合并CSR患者20例的临床资料、电生理数据进行分析比较。结果CTS患者81例中，有123条正中神经传导异常，其中单侧39例，双侧42例。CTS合并CSR患者20例中，有31条正中神经传导异常，其中单侧9例，双侧11例；C6、C7水平受累者，感觉传导速度（SCV）异常率为100％，C8水平受累者，运动末端潜伏期（DML）异常率为92．3％。CTS合并CSR患者中指至腕的SCV异常率高于CTS患者（P〈0．05）。结论CSR对近端神经的根性损害，可能会导致远端正中神经对卡压更敏感，增加了患CTS的风险，但并未发现因双卡压所造成的正中神经的损害程度较单卡压更严重。Objective To investigate the electrophysiological characteristics of carpal tunnel syndrome （CTS） and CTS-associated cervical spondylotic radiculopathy （CSR） , and to examine the relationship between CTS and CSR. Methods The clinical characteristics and electrodiagnostic features of 81 patients with CTS and 20 patients with both CTS and CSR （the double crush, DC ） were analyzed and compared. The data were analyzed according to the severity of the deficit in median nerve conduction using electromyography. Results The 81 patients with CTS had 123 median nerves with abnormal conduction （39 cases with unilateral abnormalities and 42 cases with bilateral abnormalities）. The 20 patients with DC had 31 median nerves with abnormal conduction （9 cases with unilateral abnormalities and 11 cases with bilateral abnormalities ）. The rate of abnormal sensory nerve conduction velocity （SCV） was 100% in Cs and C7 level radiculopathies. The rate of abnormal distal motor latency （DML） was 92.31% in C5 level radiculopathies. There was a statistically significant difference between CTS and DC in the rate of abnormal SCV from the middle finger to the wrist. The other electrodiagnostic data were not significantly different between the CTS and DC patients. Neurophysiological tests were used to grade CTS into categories according to the American Association of Electrodiagnostic Medicine＇s criteria, but there was no statistically significant difference between CTS and DC. Conclusions CSR lesions on a proximal nerve root may cause the nerve to be more susceptible to distal injury and increase the risk of CTS. The findings support the DC hypothesis, but DC on a median nerve did not result in more severe injury than a single crush.

关 键 词：腕管综合征 神经根型颈椎病 双卡压 肌电图 

分 类 号：R688[医药卫生—骨科学]