运动神经传导速度在肘管综合征分型中的应用  

Application of motor nerve conduction velocity in the classification of cubital tunnel syndrome

作　　者：张宏亮 李身泰 李明[1] 宋永周[1] 张华[1] 马维[1] ZHANG Hong-liang;LI Shen-tai;LI Ming;SONG Yong-zhou;ZHANG Hua;MA Wei(Department of Orthopedics,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院骨科,河北石家庄050000

出　　处：《河北医科大学学报》2019年第3期296-299,共4页Journal of Hebei Medical University

摘　　要：目的观察运动神经传导速度(motor nerve conduction velocity,MNCV)不同的肘管综合征患者的手术效果,探讨MNCV在肘管综合征分型中的应用。方法将行尺神经松解皮下前置术的60例肘管综合征患者,依据尺神经跨肘段MNCV分为3组:甲组(MNCV>40m/s)20例;乙组(MNCV30～40m/s)20例;丙组(MNCV<30m/s)20例。术后比较3组环指和小指麻痛感、感觉检查、握力、骨间肌萎缩、爪形手程度及恢复情况。结果术后综合疗效甲组、乙组、丙组优良率分别为90.0%(18/20)、85.0%(17/20)、45.0%(9/20),甲组和乙组综合疗效均优于丙组,差异有统计学意义(P<0.05)。甲组和乙组术后骨间肌萎缩、握力及爪形手恢复情况均好于丙组,差异有统计学意义(P<0.05)。结论 MNCV可单独作为肘管综合征的分型指标,值得在临床上推广应用。当MNCV>40m/s时为轻度,可以保守治疗,但需定期复查MNCV,如果MNCV继续减慢,则应采取手术治疗;当MNCV介于30～40m/s时应手术治疗,手术效果良好;当MNCV<30m/s时,应及早手术治疗,但手术后仍可遗留残疾。Objective To explore the application in the classification of cubital tunnel syndrome by studying the surgical effect of patients with cubital tunnel syndrome(CuTS)when its motor nerve conduction velocity(MNCV)is different.Methods Sixty patients with cubital tunnel syndrome who underwent ulnar nerve relaxation and subcutaneous anterior transposition were divided into three groups according to MNCV.A group:MNCV is >40 m/s.B group:MNCV is 30-40 m/s.C group:MNCV is<30 m/s.Results The excellent and good results of postoperative comprehensive effect in the three groups were:90.0%(18/20),85.0%(17/20),and 45.0%(9/20).The comprehensive effects of group A and group B were better than those of group C,and the difference was statistically significant(P<0.05).The recovery of interosseous muscle atrophy,grip strength and claw-shaped hand in group A and group B were better than those in group C,and the difference was statistically significant(P<0.05).Conclusion The motor nerve conduction velocity can be classified as cubital tunnel syndrome alone,and it is worth being popularized in clinics.When MNCV is >40 m/s,it is mild and we can choose conservative treatment,but the MNCV should be regularly reviewed,if the MNCV is continue to slow down,surgical treatment should be taken.When the MNCV is 30-40 m/s,it is moderate and we should choose surgery treatment and the effect of surgery is good.When MNCV is<30 m/s,we should choose surgical treatment as early as possible but the postoperative effect is poor.

关 键 词：肘管综合征 运动神经传导速度 分型 

分 类 号：R745[医药卫生—神经病学与精神病学]