高频超声与神经肌电图在肘部尺神经卡压病变中的诊断优势比较  

Comparison of diagnostic advantages of high frequency ultrasound and neuroemg in the entrapment of the ulnar nerve of the elbow

作　　者：索燕花 王丽 董燕 董洁 SUO Yan-hua;WANG Li;DONG Yan(Color Ultrasound Room of Functional Department,Zhangye People's Hospital Affiliated to Hexi University,Zhangye Gansu 734000,China;Color Ultrasound Room of Physical Examination Center,Zhangye People's Hospital Affiliated to Hexi University,Zhangye Gansu 734000,China;Electromyography Room,Zhangye People's Hospital Affiliated to Hexi University,Zhangye Gansu 734000,China)

机构地区：[1]河西学院附属张掖人民医院功能科彩超室,甘肃张掖734000 [2]河西学院附属张掖人民医院体检中心彩超室,甘肃张掖734000 [3]河西学院附属张掖人民医院肌电图室,甘肃张掖734000

出　　处：《临床和实验医学杂志》2022年第13期1454-1456,F0003,共4页Journal of Clinical and Experimental Medicine

基　　金：甘肃省级自然科学基金课题项目(编号:20JR5RA195)。

摘　　要：目的分析高频超声与神经肌电图在肘部尺神经卡压病变中的诊断优势。方法回顾性选择自2018年1月至2021年1月河西学院附属张掖人民医院接诊的280例肘部尺神经卡压病变患者作为观察组,另选同期的140名健康体检者作为对照组。所有受试者均接受高频超声和神经肌电图检查,其中高频超声检测肘部尺神经的横径、前后径及最大横截面积(CSA),神经肌电图检测肘上-肘下段运动传导速度(MCV)、肘-腕段MCV、小指至腕感觉传导速度(SCV),使用Pearson相关性分析高频超声参数与神经肌电图参数的关系,比较两组方法诊断肘部尺神经卡压病变的准确率。结果观察组肘部尺神经的CSA为(8.15±1.48)mm^(2),大于对照组[(5.93±1.06)mm^(2)],差异有统计学意义(P<0.05)。观察组肘上-肘下段MCV、肘-腕段MCV、小指至腕SCV为(28.76±10.13)、(36.91±12.05)、(22.32±8.92)m/s,均小于对照组[(56.92±4.54)、(57.12±5.63)、(55.81±4.07)m/s],差异均有统计学意义(P<0.05)。经Pearson相关性分析,肘部尺神经卡压病变患者肘部尺神经的CSA与肘上-肘下段MCV、肘-腕段MCV、小指至腕SCV均呈负相关(r=-0.762、-0.483、-0.451,P<0.05)。高频超声准确诊断肘部尺神经卡压病变262例,另20例诊断为正常,8例误诊为胸廊出口综合征,均经神经肌电图诊断;神经肌电图准确诊断肘部尺神经卡压病变258例,另9例诊断为正常,13例定位不准确,均经高频超声诊断;高频超声和神经肌电图诊断肘部尺神经卡压病变的准确率分别为93.57%、92.14%,差异无统计学意义(P>0.05)。结论高频超声和神经肌电图均对肘部尺神经卡压病变具有很好的诊断价值,前者可清晰显示尺神经形态,后者可判断尺神经功能状态,两者联合应用能够为肘部尺神经卡压病变的诊治提供更高级证据支持。Objective To analyze the diagnostic advantages of high frequency ultrasound and neuroemg in the entrapment of the ulnar nerve of the elbow.Methods A total of 280 patients with entrapment of the ulnar nerve at the elbow in Zhangye People's Hospital Affiliated to Hexi University from January 2018 to January 2021 were retrospectively selected as the observation group,and 140 healthy subjects during the same period were selected as the control group.All subjects underwent high frequency ultrasound and neuroelectromyography,in which the transverse diameter,anterior and posterior diameter and maximum cross-sectional area(CSA)of the ulnar nerve of the elbow were measured by high frequency ultrasound,the motor conduction velocity(MCV)of the upper to lower elbow,the MCV of the elbow to wrist,and the sensory conduction velocity(SCV)of the little finger to wrist were measured by neuroelectromyography.Pearson correlation analysis was used to analyze the relationship between high-frequency ultrasound parameters and neuroemg parameters to compare the accuracy of the two methods in diagnosing the entrapment of the ulnar nerve at the elbow.Results CSA of elbow ulnar nerve in the observation group was(8.15±1.48)mm 2,which was higher than that in the control group[(5.93±1.06)mm 2],the difference was statistically significant(P<0.05).The MCV of the upper elbow-lower elbow segment,the MCV of the elbow-wrist segment,and the SCV of the little finger to the wrist in the observation group were(28.76±10.13)m/s,(36.91±12.05)m/s,(22.32±8.92)m/s,which were lower than those in the control group[(56.92±4.54)m/s,(57.12±5.63)m/s,(55.81±4.07)m/s],the differences were statistically significant(P<0.05).According to Pearson correlation analysis,CSA of ulnar nerve of elbow was negatively correlated with MCV of upper elbow-lower elbow-wrist,MCV of elbow-wrist and SCV of little finger to wrist(r=-0.762,-0.483,-0.451,P<0.05).High frequency ultrasound accurately diagnosed 262 cases of ulnar nerve compression at elbow,20 cases were diagnosed as n

关 键 词：肘部尺神经卡压病变 高频超声 神经肌电图 最大横截面积 运动传导速度 

分 类 号：R445.1[医药卫生—影像医学与核医学] R688[医药卫生—诊断学]