创伤性脊髓损伤患者双下肢神经传导检测和针肌电图特征分析  

Analysis of Nerve Conduction and Needle Electromyography in Lower Extremities of Patients with Traumatic Spinal Cord Injury

作　　者：胡裕君[1] 陈霏潼 曹湾 刘夕霞[1] 陈启波[1] Hu Yujun;Chen Feitong;Cao Wan;Liu Xixia;Chen Qibo(Department of Rehabilitation Medicine,The People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西壮族自治区人民医院康复医学科,广西壮族自治区南宁530021

出　　处：《中国社区医师》2023年第28期161-163,共3页Chinese Community Doctors

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(编号:Z20170317)。

摘　　要：目的:分析创伤性脊髓损伤患者双下肢神经传导和肌肉自发电位的特点。方法:选取2014年6月—2020年7月广西壮族自治区人民医院康复医学科收治的创伤性脊髓损伤患者29例作为研究对象,采用常规神经传导检测方法测定双下肢运动神经复合肌肉动作电位潜伏期、波幅和传导速度,感觉神经传导电位的波幅、传导速度。采用一次性针电极插入放松的双侧股内侧肌、胫前肌、腓肠肌检测自发电位。结果:29例患者经检测示,运动神经传导异常24例(占比82.8%),其中波幅减低或未引出波形22例(占比91.7%),伴有腓肠神经感觉传导异常4例(占比16.7%);胫神经运动传导异常15例(占比51.7%),其中双侧异常13例(占比44.8%),单侧异常2例(占比6.9%);腓总神经运动传导异常21例(占比72.4%),其中双侧异常15例(占比51.7%),单侧异常6例(占比20.7%);腓肠神经感觉传导异常4例(占比13.8%),其中双侧异常3例(占比10.3%),单侧异常1例(占比3.4%)。腓总神经运动传导异常率与胫神经运动传导异常率比较,差异无统计学意义(P>0.05)。颈髓、胸髓和腰髓损伤患者的胫神经运动传导、腓总神经运动传导和腓肠神经感觉传导异常率比较,差异无统计学意义(P>0.05)。双下肢肌肉见不同程度的异常自发电位28例(占比96.6%)。结论:创伤性脊髓损伤患者神电生理主要表现为运动神经轴索性损害,且大部分损害部位在脊髓灰质和/或脊髓至椎间孔之间的神经根。Objective:To Analyze the nerve conduction and needle electromyography in lower extremities of patients with traumatic spinal cord injury.Methods:A total of 29 patients with traumatic spinal cord injury were selected as the study objects at the Rehabilitation Medicine Department of the People's Hospital of Guangxi Zhuang Autonomous Region from June 2014 to July 2020.Conventional nerve conduction detection methods were used to determine the latency,amplitude and conduction velocity of motor nerve complex muscle action potentials of both lower limbs,and the amplitude and conduction velocity of sensory nerve conduction potentials.The spontaneous potential was detected by using disposable needle electrodes inserted into the relaxed bilateral vastus medialis muscle,tibialis anterior muscle and gastrocnemius muscle.Results:Among the 29 patients,abnormal motor nerve conduction was found in 24 cases(82.8%),of which 22 cases(91.7%)had reduced amplitude or no waveform,and 4 cases(16.7%)were accompanied by abnormal sensory conduction of sural nerve.There were 15 cases(51.7%)of abnormal tibial nerve motor conduction,including 13 cases(44.8%)of bilateral abnormalities and 2 cases(6.9%)of unilateral abnormalities.There were 21 cases(72.4%)of common peroneal nerve motor conduction abnormalities,of which 15 cases(51.7%)were bilateral abnormalities and 6 cases(20.7%)were unilateral abnormalities.Abnormal sensory conduction of sural nerve was found in 4 cases(13.8%),of which 3 cases were bilateral(10.3%)and 1 case was unilateral(3.4%).There was no significant difference in motor conduction abnormality between peroneal nerve and tibial nerve(P>0.05).There was no significant difference in the abnormal rates of tibial nerve motor conduction,common peroneal nerve motor conduction and sural nerve sensory conduction in patients with cervical,thoracic and lumbar spinal cord injury(P>0.05).Abnormal spontaneous potentials were found in 28 cases(96.6%)in both lower extremity muscles.Conclusion:The electrophysiological manifestations of patie

关 键 词：脊髓损伤 周围神经 神经传导 肌电图 

分 类 号：R651.2[医药卫生—外科学]