腕管综合征患者尺神经功能的神经电生理评价  

Electrophysiological evaluation of ulnar nerve in carpal tunnel syndrome

作　　者：刘娜[1] 张哲成[1] 郑丽娜[1] 朱炬[1] 张静[1] 

机构地区：[1]天津市第三中心医院神经内科,300170

出　　处：《中华神经科杂志》2013年第12期836-839,共4页Chinese Journal of Neurology

摘　　要：目的 应用神经电生理方法评价腕管综合征（carpal tunnel syndrome,CTS）患者尺神经功能状态及其与尺神经支配区域感觉症状有无相互关系.方法 选取2012年1月至2013年2月就诊于我院的CTS患者55例,根据Stevens标准分为轻中度组35例、重度组20例,进一步按症状发作时是否伴有小指区域感觉症状分有症状组和无症状组,选择健康志愿者20名作为对照,应用Keypoint.net（Medoc Ltd）肌电图仪进行正中神经、尺神经电生理检测.结果 CTS组与对照组相比较,尺神经指5-腕感觉传导速度（SCV）减慢[（51.71±2.93） m/s与（58.62±3.21） m/s,t=8.80,P＜0.01]、感觉神经动作电位（SNAP）波幅差异无统计学意义.Pearson相关性分析提示尺神经指5-腕SCV、SNAP波幅与正中神经末端运动潜伏期呈负相关,与正中神经复合肌肉动作电位波幅、指1-腕、指3-腕SCV、SNAP波幅呈正相关.轻中度组中与无症状组相比,有症状组尺神经指5-腕SCV减慢、SNAP波幅减低[（51.59±2.70） m/s与（53.72±2.58） m/s;（13.51±1.84） μV与（15.21 ±2.16）μV,t=2.24、2.30,均P＜0.05],而重度组中只有2例出现小指区域感觉症状.结论 CTS患者存在尺神经腕部卡压性损害,随疾病进展加重;尺神经支配区感觉症状多发生于轻中度组CTS患者且可能与尺神经受累有关.Objective To evaluate the impairment of ulnar nerve and its relationship with sensory symptoms in the ulnar territory in patients with carpal tunnel syndrome （CTS） through electrophysiological approach. Methods We retrospectively reviewed 55 cases with CTS admitted in our hospital from January 2012 to February 2013. Patients with CTS were graded as mild-moderate （35 cases） and severe （20 cases） according to Stevens standard and were divided into symptomatic and non-symptomatic group according to the presence of sensory symptom in little finger region. Twenty healthy volunteers were included as control. Median and ulnar nerves electrophysiological study were performed using the Keypoint. net （ Medoc Ltd） electromyogram device. Results Finger 5-wrist sensory conduction velocities （SCVs） of ulnar nerve were reduced （ （51.71 -＋ 2. 93 ） m/s vs （58. 62 ＋ 3.21 ） m/s, t = 8.80, P 〈 0. 01 ） in CTS group, compared with control group. But the sensory nerve action potential （SNAP） amplitudes had no difference. Pearson correlation analysis showed that finger 5-wrist SCVs and the SNAP amplitudes of ulnar nerve were negatively correlated with the distal motor latency of the median nerve, while positively correlated with the compound muscle action potential amplitudes, finger 1-wrist, finger 3-wrist SCVs and SNAP amplitudes of median nerve,in mild-moderate group, finger 5-wrist SCVs of ulnar nerve were slowed and the SNAP amplitudes were reduced （（51.59±2.70） m/svs （53.72±2.58） m/s; （13.51 ±1.84） μVvs （15.21 ±2. 16） μV,t= 2. 24,2. 30, P 〈 0. 05 respectively ） in the symptomatic group, compared with the non-symptomatic group. However, in severe group, only 2 cases had sensory symptom in little finger region. Conclusions CTS patients may have impairments due to ulnar nerve entrapments at wrist, which aggravate with disease progression. Sensory symptoms in ulnar territory are more frequent during the mild-moderate stage, and may relate with ulnar nerve involvemen

关 键 词：腕管综合征 尺神经 神经传导 肌电描记术 

分 类 号：R688[医药卫生—骨科学]