足下垂病人的电生理诊断分析  

ELECTROPHYSIOLOGICAL DIAGNOSIS OF PATIENTS WITH FOOT DROP

作　　者：齐宗华[1] 刘勇[1] 齐宗辉 QI Zonghua LIU Yong QI Zonghui(Depart- ment of Spine Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003, Chin)

机构地区：[1]青岛大学附属医院脊柱外科,山东青岛266003 [2]青岛阜外医院特需科

出　　处：《青岛大学医学院学报》2016年第6期670-671,675,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的探讨电生理检查对足下垂病人腰骶与腓总神经病变的鉴别价值。方法对72例足下垂病人行双下肢胫神经与腓总神经运动传导、胫神经F波及H反射、腓浅神经及腓肠神经感觉传导及胫前肌、腓骨长肌、股二头肌、腓肠肌、臀大肌、阔筋膜张肌及腰椎棘旁肌肌电图检查,通过下肢周围神经及相关肌肉的肌电图表现,对神经根及周围神经病变进行诊断。结果通过临床表现及影像学检查初诊为腰骶神经根病变42例中,经神经肌电图检查诊断为腓总神经病变5例,腰5病变28例,腰5骶1病变9例。根据临床表现初诊为腓总神经病变30例中,经神经肌电图检查诊断为腰5神经根病变7例,腰5骶1神经根病变2例,腰骶干病变1例,腓深神经病变1例,腓总神经病变18例,坐骨神经并腓总神经支病变1例。结论对于足下垂病人单纯根据临床表现及影像学检查进行诊断误诊较多,而神经肌电图检查能客观、准确地鉴别腰骶与腓总神经病变。Objective To assess the value of electrophysiological examination in differential diagnosis of lumbosacral nerve lesions and common peroneal nerve in patients with foot drop. Methods An electromyography examination was conducted in 72 patients with foot drop. The items examined were as follows： motor conduction of the tibial nerve and the common motor nerve of the lower limbs, F wave and H reflex of tibial nerve, superficial peroneal nerve and sural nerve sensory transduction, tibialis anterior muscle, peroneus longus muscle, biceps femoris muscle, gastrocnemius muscle, gluteus maximus muscle, tensor fasciae latae muscle and paraspinal muscles of lumbar vertebrae. Objective diagnostic criteria of nerve root and peripheral nerve lesions were then provided based on lower limb peripheral nerve and involved muscle electromyography manifestations. Results According to clinical manifestations and imaging examination, in 42 cases that preliminarily diagnosed as L5 nerve root lesions, five were diagnosed as common peroneal nerve lesions using neuromuscular electrical diagram, 28 of L5 lesions and nine of L5 and S1 lesions. In 30 cases of preliminarily diagnosed as common peroneal nerve lesions according to clinical manifestations, after nerve eleetromyography, seven cases were diagnosed as L5 nerve root lesions, two of L5 associated with S1 lesions, one of lumbosacral trunks lesion, one of deep nerve lesion, 18 of common peroneal nerve lesion and one of common peroneal nerve branch lesion. Conclusion Diagnosis of foot drop patients simply based only on clinical manifestations and imaging will make large misdiagnosis, and nerve electromyography can make an objective and accurate differential diagnosis of lesions of lumbar sacral nerve and the common peroneal nerve.

关 键 词：足下垂 脊神经根 神经卡压综合征 肌电描记术 

分 类 号：R681[医药卫生—骨科学]