肘管综合征患者神经电生理特点  

Neuroelectrophysiological characteristics of patients with cubital tunnel syndrome

作　　者：李贵阳 张立霞[1] Li Guiyang;Zhang Lixia(Department of Electrophysiology,Weifang Hospital of Traditional Chinese Medicine,WeiFang City,Shandong Province,261041,China)

机构地区：[1]潍坊市中医院电生理室,山东省潍坊市261041

出　　处：《现代电生理学杂志》2022年第1期12-15,共4页Journal of Modern Electrophysiology

摘　　要：目的:探讨肘管综合征(CuTS)患者的神经电生理特点。方法:收集2019年3月至2020年1月就诊于潍坊市中医院的CuTS患者98例,其中单侧肘管综合征92例,双侧肘管综合征6例,受检尺神经104条。分析其临床资料及神经电生理数据。结果:104条受检尺神经中,46条尺神经复合肌肉动作电位(CMAP)末端潜伏期≥3.2 ms,异常率44.2%;61条尺神经CMAP波幅<5.0 mV,异常率58.6%;54条尺神经肘下-腕段运动神经传导速度(MCV)<50.0 m/s,异常率51.9%;94条尺神经肘上-肘下段MCV<45.0 m/s,异常率90.4%;34条尺神经CMAP波幅肘上-肘下段较肘下-腕段下降超过20%,异常率32.7%。71条尺神经感觉动作电位(SNAP)未引出,异常率68.3%;86条尺神经腕-小指段SNAP波幅<8.0 mV,异常率82.7%;78条尺神经腕-小指段感觉神经传导速度<50.0 m/s,异常率75.0%。结论:尺神经肘上-肘下段MCV诊断CuTS的敏感性最高,早期确诊及准确定位尺神经受损部位及损伤程度,对CuTS的诊断、鉴别诊断有重要价值,对治疗及预后有重要指导意义。Objective:To explore the neuroelectrophysiological characteristics of pat ients with cubital tunnel syndrome(CuTS).Methods:A total of 98 patients with CuTS in Weifang Hospital of Traditional Chinese Medicine from March 2019 to January 2020 were enrolled,including 92 cases of unilateral CuTS,6 cases of bilateral CuTS,and 104 ulnar nerves were examined.Clinical data and neuroelectrophysiological data were analyzed.Results:Among 104 ulnar nerves,the distal motor latency of complex muscle action potential(CMAP)was≥3.2 ms in 46 ulnar nerves,and the abnormal rate was 44.2%.The amplitude of CMAP was less than 5.0 mV in 61 ulnar nerves,with the abnormal rate 58.6%.The motor nerve conduction velocity(MCV)of 54 ulnar nerves was less than 50.0 m/s in lower elbow to wrist segment,with the abnormal rate 51.9%.The MCV of 94 ulnar nerves above to below elbow segment was less than 45.0 m/s,with the abnormal rate 90.4%.The amplitude of CMAP of 34 ulnar nerves in above to below elbow segment decreased by more than 20%compared with that in lower elbow to wrist segment,with the abnormal rate 32.7%.The sensory action potential(SNAP)was not elicited in 71 ulnar nerves,and the abnormal rate was 68.3%.The amplitude of SNAP of 86 ulnar nerves in wrist to little finger segment was less than 8.0 mV,and the abnormal rate was 82.7%.The sensory nerve conduction velocity of 78 ulnar nerves in wrist to little fingers egment was less than 50.0 m/s,and the abnormal rate was 75.0%.Conclusion:MCV of ulnar nerve in above to below elbow segment has the highest sensitivity in the diagnosis of CuTS.Early diagnosis and accurate positioning of the damaged site and degree of ulnar nerve are of great value in the diagnosis,diff erential diagnosis,treatment and prognosis of CuTS.

关 键 词：肘管综合征 肌电描记术 诊断 鉴别 

分 类 号：R688[医药卫生—骨科学]