神经电生理在小腿骨筋膜室综合征患者预后恢复中的应用价值  

The prognostic value of neuroelectrophysiology in patients with calf compartment syndrome

作　　者：陈思聪 吴锋锋[2] 范星星 CHEN Si-cong;WU Feng-feng;FANG Xing-xing(Department of Neurology,Huzhou Central Hospital,Huzhou 313000,Zhejiang,China;不详)

机构地区：[1]湖州市中心医院、湖州师范学院附属中心医院神经内科,浙江湖州313000 [2]湖州市中心医院、湖州师范学院附属中心医院神经内科骨科,浙江湖州313000

出　　处：《广东医学》2020年第10期1019-1022,共4页Guangdong Medical Journal

基　　金：浙江省科技计划项目(2017C33222)。

摘　　要：目的探讨神经电生理在小腿骨筋膜室综合征患者预后恢复的应用价值。方法选取65例诊断为小腿骨筋膜室综合征患者分别已于半年及1年进行神经电生理检查,观察其恢复及预后情况,包括针极肌电图(EMG):胫前肌、腓骨长肌、伸拇长肌、趾短伸肌、腓肠肌内侧头、比目鱼肌、趾短屈肌;运动神经传导速度(MNCV):腓总神经、胫神经;感觉神经动作电位(sensory nerve action potential,SNAP):腓浅神经、腓肠神经。结果损伤后半年及1年复查肌电图显示腓总神经支配肌自发电明显少于胫神经支配肌;MUP发放阳性率腓总神经也较胫神经减少;腓总神经、胫神经MNCV提示半年及1年后胫神经恢复明显好于腓总神经,腓浅神经、腓肠神经SNAP波幅提示半年及1年后腓肠神经恢复明显好于腓浅神经。结论肌电图对小腿骨筋膜室综合征患者有重要诊断意义,可为临床损伤定性,对预后判断有指导意义,也为神经电生理工作者在诊断小腿骨筋膜室综合征神经损伤时,提供一定的参考价值。Objective To investigate the prognostic value of neuroelectrophysiology in patients with calf compartment syndrome.Methods A total of 65 patients diagnosed with calf compartment syndrome were enrolled from March 2015 to April 2019.Neurophysiological examinations were performed six months and one year after the injury.The examinations included electromyography(EMG)of the tibialis anterior,peroneus longus,extensor hallucis longus,extensor digitorum brevis,medial head of gastrocnemius,soleus,and flexor brevis digitorum;motorized conduction velocity(MNCV)ofthe nervus peroneus communis andtibial nerve;and sensory nerve action potential(SNAP)ofthe superficial peroneal nerveandsural nerve.Results EMG examination six months and one year after the injury showed that spontaneous potential ofthe muscle innervation bynervus peroneus communis was significantly less thanthat innervation by the tibial nerve,as well as the motor unit potential(MUP)release.Moreover,the MNCV suggested that the tibial nerve recovery was significantly better than nervus peroneus communis 6 months and 1 year after injury.The SNAP amplitude demonstrated that the recovery of the sural nerve was significantly better than that of the superficial peroneal nerve 6 months and 1 year after injury.Conclusion EMG has important diagnostic significance for patients with calf compartment syndrome.Itis available for qualitative diagnosis and prognosisof this injury.It also provides aneffective reference value for neuroelectrophysiologists.

关 键 词：小腿骨筋膜室综合征 神经电生理 腓总神经 胫神经 

分 类 号：R338.8[医药卫生—人体生理学] R686.3[医药卫生—基础医学]