高频超声在诊断正中神经返支卡压中的临床价值  

The Value of Clinical Classification Decision of Carpal Tunnel Syndrome in Recurrent Median Nerve Entrapment Syndrome by High Frequency Ultrasonography

作　　者：刘英[1] 李春生 马琳 雷虹[1] 马玲玲 Liu Ying;Li Chunsheng;Ma Lin;Lei Hong;Ma Lingling(Department of Ultrasound,the Second Hospital of Tangshan,Tangshan,Hebei 063000,China;Qingsongling Health Centre of Xinglong Country,Chengde,Hebei 067300,China;Department of Ultrasound,North China University of Science and Technology,Tangshan,Hebei 063000,China)

机构地区：[1]唐山市第二医院超声科,河北省唐山市063000 [2]承德市兴隆县青松岭中心卫生院 [3]华北理工大学附属医院超声科

出　　处：《中国超声医学杂志》2018年第10期929-931,共3页Chinese Journal of Ultrasound in Medicine

基　　金：唐山市科技计划自筹经费项目(No.17130234a)

摘　　要：目的探讨高频超声检查在诊断正中神经返支卡压中的临床意义。方法病变组:选取我院(骨科专科医院)的中、重度腕管综合征(CTS)手术患者132例(单侧患病),手术证实同时存在正中神经主干及返支双重卡压患者23例作为病变组;对照组:健侧作为对照组。上述132例患者术前均行高频超声检查。结果 (1)132例患者中,23例存在正中神经主干及返支双重卡压,发生率为17.4%;(2)病变组高频超声显示:正中神经返支增粗、水肿、回声减低、神经纤维束回声模糊;大鱼际肌回声增强、变薄;(3)超声测量:病变组返支起始部内径(0.155±0.027)cm,对照组内径(0.087±0.011)cm,差异有统计学意义(P<0.05),表明:存在正中神经返支卡压时返支内径增粗;病变组大鱼际肌厚度(0.820±0.282)cm,对照组厚度(1.297±0.301)cm,差异有统计学意义(P<0.05),表明:存在返支卡压的患者大鱼际肌存在不同程度的萎缩变薄;(4)病变组术中测量返支起始部内径(0.161±0.028)cm,超声测量(0.155±0.027)cm,差异无统计学意义(P>0.05),表明:高频超声对于正中神经返支病变测量的准确性。结论中、重度CTS患者,检查正中神经主干的同时,提示返支是否卡压的声像图特征,可为临床医师提供客观诊断依据,有助于临床医师选择恰当的手术方案,提高腕管综合征的手术疗效。Objective To analyze the value of clinical classification decision of recurrent median nerve entrapment syndrome（RMNES） by ultrasonography. Methods 132 patients （unilateral fall ill） with mild and medium cases of recurrent median nerve entrapment syndrome were admitted to the second hospital of Tangshan（Orthopedic hospital） from to be the case group. As the control group,64 healthy volunteers （ 128 wrists） who have the same age and sex were admitted, too. Results （1） 23 patients had trunk and recurrent median nerve entrapment of 132 patients,and the occurrence rate was 17.4% ;（2）The case group showed： the recurrent median nerve became coarsen,edema,echo reduction, echo blur of Neural fasciculus; （3）As compared with case group （0.155 ±0.027） cm and control group （0. 087± 0.011） cm, the internal diameter of anterior recurrent median never coarsened in case group（P〈0.05）, proving that the internal diameter coarsen when recurrent median never entrapment; （4）As compared with case group （0. 820 ± 0. 282）cm and control group（1. 297 ± 0. 301）cm, the thenar muscles became thin and echo enhancement in case group （P〈0.05）, proving that thenar muscles thin even atrophy inordinately when recurrent median never entrapment;（5） As compared with the internal diameter of anterior recurrent median never by intraoperative measurement （0. 161±0. 028）cm and ultrasonic measurement（0. 155±0. 027）cm,and there was no statistical significance （P〉0.05） ,proving that high frequency ultrasonography had the veracity in recurrent median nerve lesion. Conclusions The ultrasonic characteristic of carpal tunnel syndrome trunk and recurrent median nerve entrapment can provide objective diagnostic basis for clinicists,help clinicists to choose the proper surgery programs,and improve the surgery effect of carpal tun nel syndrome.

关 键 词：高频超声 腕管综合征 正中神经返支 卡压 

分 类 号：R445.1[医药卫生—影像医学与核医学] R688[医药卫生—诊断学]