正中神经损伤的单中心前瞻性研究  

A single-center prospective study of median nerve injury

作　　者：吴立杰 邹晓莹[2] 庞燕[2] 田宇[1] 王维[1] 王宝石[1] WU Li-jie;ZOU Xiao-ying;PANG Yan(First Hospi tal of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院手足外科,河北秦皇岛066000 [2]秦皇岛市第一医院神经内科功能检查室,河北秦皇岛066000

出　　处：《中国实验诊断学》2023年第5期512-515,共4页Chinese Journal of Laboratory Diagnosis

基　　金：河北省医学科学研究课题计划项目(0211305)。

摘　　要：目的运用神经电生理检测的方法评估频繁使用腕部工作后正中神经功能受损及恢复与时间的关系。方法选取11例频繁使用腕部的男性零件装配工人,设定试验观察周期为63天,分别第1天、第11天、第21天及休息6周后检测正中神经的传导功能。结果第21天时,有9人达到腕管综合征(CTS)的电生理诊断标准,其中正中神经的平均远端运动潜伏期(DML)增加了0.41 ms(P<0.001),食指的平均感觉神经传导速度(SNCV)减少了6.3 m/s(P<0.001),中指的平均SNCV减少了6.2 m/s(P<0.001),休息6周后,正中神经的上述功能参数均恢复到正常水平。结论对于手腕部活动较多的工人,正中神经传导功能受损在第21天即可出现,休息6周后可得到明显恢复。运用电生理检测的方法,可以早期诊断正中神经损伤。Objective The purpose of this study was to evaluate the impairment and recovery of median nerve function after frequently using wrist to work with electrophysiological examination.Methods Selected 1l male parts-assembly workers who frequently used their wrists and set 63 days as the observation period.The NCS was used to detect the conduction function of median nerve in day 1,day 1l,day 21 and 6 weeks after taking a rest.Results In day 21,there are nine patients metting the electrophysiological diagnosis of Carpal Tunnel Syndrome(CTS).The mean distal motor latency(DML)of median nerve had increased 0.41 ms(P<0.001).Besidea,mean sensory nerve conduction velocity(SNCV)digit 2 had decreased 6.3 m/s(P<0.001)and mean SNCV digit 3 had decreased 6.2 m/s(P<0.001).However,the aboving functional parameters of median nerve returned to normal 6 weeks after taking a rest.Conclusion For workers with more wrist movement,median nerve conduction impairment appeared on day 21 and recovered significantly after 6 weeks of rest.Median nerve injury can be diagnosed early by electrophysiological examination.

关 键 词：腕管综合征 正中神经 电生理检测 职业暴露 

分 类 号：R741.04[医药卫生—神经病学与精神病学]