高频超声联合神经电生理检查在尺神经肘管卡压中的应用价值  

Application value of high-frequency ultrasonography combined with nerve electrophysiological examination in ulnar nerve entrapment at the elbow

作　　者：樊宝华[1] 钟文翔[2] 张文川 Fan Baohua;Zhong Wenxiang;Zhang Wenchuan(Department of Neurosurgery,the Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200011,China;Department of Neurosurgery,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属第九人民医院神经外科,200011 [2]上海交通大学医学院附属新华医院神经外科,200092

出　　处：《中国微侵袭神经外科杂志》2020年第5期201-204,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：国家自然科学基金项目(编号:81371373、81771320、81801219);上海市科委科技支撑项目(编号:17411966300)。

摘　　要：目的探讨高频神经超声联合神经电生理检查在尺神经肘管卡压中的应用价值。方法回顾性分析186例尺神经肘管卡压病人的临床资料,其中Mc GowanⅠ级96例,Ⅱ级68例,Ⅲ级22例;均进行尺神经皮下前置减压手术。所有病人随访2年,手术前后检测尺神经横截面积(cross section area,CSA)、运动传导速度(motor conduction velocity,MCV)、感觉传导速度(sensory conduction velocity,SCV)和神经动作电位(nerve action potential,NAP)作为诊断和疗效评估指标。结果 Mc GowanⅠ、Ⅱ、Ⅲ级皮下前置术后的优良率分别为87.5%、72.1%、63.6%。术前Mc GowanⅠ级健侧与病侧CSA、MCV、SCV、NAP差异均有统计学意义(P <0.05);术前Mc GowanⅠ、Ⅱ、Ⅲ级间CSA、MCV、SCV、NAP差异均有统计学意义(P <0.05);Mc GowanⅠ、Ⅱ、Ⅲ级术后2年的CSA、MCV、SCV、NAP均较术前显著改善(P <0.05)。结论高频神经超声联合神经电生理检查可应用于尺神经肘管卡压的临床诊断和手术疗效评价。Objective To explore the clinical value of high-frequency ultrasound combined with nerve electrophysiological examination in ulnar nerve entrapment at the elbow(UNEE). Methods Clinical data of 186 patients with UNEE were analyzed retrospectively,including Mc Gowan grade Ⅰ in 96 patients, grade Ⅱ in 68 and grade Ⅲ in 22. All the patients were treated with subcutaneous anterior ulnar nerve transposition and followed up for 2 years. The cross section area(CSA), motor conduction velocity(MCV), sensory conduction velocity(SCV) and nerve action potential(NAP) were confirmed as evaluation indicators of diagnosis and therapeutic efficacy. Results The excellent and good outcome rates of Mc Gowan grades Ⅰ, Ⅱ and Ⅲ were 87.5%, 72.1% and 63.6% respectively.There were significant differences in CSA, MCV, SCV and NAP between uninjured side and injured side for patients with Mc Gowan grade I before the operation(P < 0.05). There were significant differences in CSA, MCV, SCV and NAP between Mc Gowan grade Ⅰ,grade Ⅱ and grade Ⅲ before the operation(P < 0.05). Compared with preoperation, CSA, MCV, SCV and NAP 2 years after operation were significantly improved for patients with Mc Gowan grades Ⅰ, Ⅱ and Ⅲ(P < 0.05). Conclusion High-frequency ultrasound combined with nerve electrophysiological examination can be applied in clinical diagnosis and evaluation of operative effect in UNEE.

关 键 词：尺神经压迫综合征 高频神经超声 神经电生理检查 减压术 

分 类 号：R319.2[医药卫生—基础医学]