跗管综合征的神经电生理诊断价值  

Diagnostic Value of Electrophysiological Examination in Tarsal Tunnel Syndrome

作　　者：陈劼 徐雷 田东 CHEN Jie;XU Lei;TIAN Dong(Department of Hand Surgery,Huashan Hospital,Fudan University,NHC Key Laboratory of Hand Reconstruction(Fudan University),Shanghai Key Laboratory of Peripheral Nerve and Microsurgery,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院手外科,卫健委手功能重建重点实验室,上海市周围神经显微外科重点实验室,上海200040

出　　处：《骨科》2022年第1期25-27,共3页ORTHOPAEDICS

基　　金：上海市临床重点专科(shslczdzk05601)。

摘　　要：目的探讨神经电生理检测对于跗管综合征的诊断价值。方法回顾性分析2019年1月至2021年11月于复旦大学附属华山医院就诊的32例(35侧)跗管综合征病人的神经电生理检测资料:(1)足内肌(小趾展肌或展肌)的复合肌肉动作电位(compound muscle action potential,CMAP);(2)足底内侧皮神经的感觉神经动作电位(sensory nerve action potential,SNAP);(3)足内肌的肌电图(electromyography,EMG)检测结果。结果足内肌CMAP的潜伏期为(6.4±2.0)ms,较健侧延长47.6%,波幅为(7.5±5.2)mV,较健侧降低59.7%;足底内侧皮神经SNAP的潜伏期为(2.4±0.6)ms,较健侧延长30.5%,波幅为(3.1±3.1)μV,较健侧降低78.4%;EMG检测结果:29侧足内肌出现自发电活动,34侧出现不同程度的主动募集反应减弱。结论CMAP、SNAP、EMG检测对诊断跗管综合征均有重要价值,其中SNAP的波幅变化最为显著。Objective To discuss the diagnostic value of electrophysiological examination in tarsal tunnel syndrome(TTS).Methods A total of 32 cases(35 sides)of tarsal tunnel syndrome who underwent electrophysiological examination in Huashan Hospital from January 2019 to December 2021 were studied retrospectively:compound muscle action potential(CMAP)of the abductor digiti quinti pedis or abductor hallucis brevis;sensory nerve action potential(SNAP)of medial plantar nerve;needle electromyography(EMG)of the abductor digiti quinti pedis or abductor hallucis brevis.Results Compared to the contralateral side,the latency(LAT)of CMAP was(6.4±2.0)ms,which was 47.6%delayed,and the amplitude(AMP)was(7.5±5.2)mV,which was reduced by 59.7%on the affected sides.The LAT of SNAP was(2.4±0.6)ms,which was delayed by 30.5%,and the AMP was(3.1±3.1)μV,which was reduced by 78.4%on the affected sides as compared with those on the contralateral sides.EMG examination revealed that spontaneous potentials were detectable on 29 sides and recruitment decreased on 34 sides.Conclusion Electrophysiological examination plays an important role in the diagnosis of TTS.The AMP of SNAP shows the highest sensitivity.

关 键 词：跗管综合征 神经电生理生理 诊断 

分 类 号：R688[医药卫生—骨科学]