神经肌电图检查联合高频超声应用于腕管综合征中的价值研究  

Value of neuromyography combined with high-frequency ultrasound in carpal tunnel syndrome

作　　者：王娆[1] 杨昀[1] 李文军[1] WANG Rao;YANG Yun;LI Wenjun(Electromyography Room,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院肌电图室,北京100035

出　　处：《安徽医学》2025年第4期426-430,共5页Anhui Medical Journal

基　　金：卫生部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)开放课题(编号:240759)。

摘　　要：目的分析神经肌电图(EMG)检查联合高频超声应用于腕管综合征(CTS)中的价值。方法选择2022年1月至2024年1月在北京积水潭医院接受治疗的93例CTS患者为研究对象(CTS组),选择同期于医院查体中心查体的35例健康人员为健康组。两组对象均行EMG检查、高频超声检查,比较两组对象EMG检查、高频超声指标变化,采用四格表法检测EMG检查联合高频超声应用于CTS中的价值。CTS组患者根据病症严重程度分为轻度组(n=30)、中度组(n=40)和重度组(n=23),并对比横截面积(CSA)、横截面积差(△-CSA)、横截面积比(R-CSA)水平变化。结果CTS组患者正中神经运动传导的运动传导速度、肌肉动作电位水平相较于健康组降低,远端潜伏期水平相较于健康组升高(P<0.05)。CTS组患者正中神经感觉传导的感觉传导速度、感觉神经运动电位水平相较于健康组降低,正中神经与尺神经的潜伏期之差值水平相较于健康组升高(P<0.05)。CTS组患者CSA、△-CSA、R-CSA水平相较于健康组升高(P<0.05)。EMG、高频超声、EMG+高频超声诊断CTS的灵敏度分别为82.61%、77.42%和91.40%,特异度分别为88.57%、82.86%和94.29%,准确度分别为79.57%、76.34%和93.55%,EMG+高频超声诊断的灵敏度、特异度及准确度均高于EMG、高频超声单一诊断(P<0.05)。结论EMG检查与高频超声检查具有较高的一致性,二者联合诊断可提高CTS诊断价值,同时高频超声可评价CTS患者病情严重程度,有助于指导治疗。Objective To analyze the value of neuromyography combined with high-frequency ultrasound in carpal tunnel syndrome(CTS).Methods A total of 93 CTS patients who were treated in Beijing Jishuitan Hospital from January 2022 to January 2024 were selected as the research subjects(CTS group),and 35 healthy people who were examined in the Physical Examination Center of the hospital during the same period were selected as the healthy group.Both groups of subjects underwent EMG examination and high-frequency ultrasound examination.The changes in EMG examination and high-frequency ultrasound indicators of the two groups were compared.The value of EMG examination combined with high-frequency ultrasound in CTS was detected by the four-cell table method.Patients in the CTS group were divided into mild group(n=30),moderate group(n=40)and severe group(n=23)according to the severity of the disease,and the changes in the levels of cross-sectional area(CSA),cross-sectional area difference(△-CSA)and cross-sectional area ratio(R-CSA)were compared.Results Compared with the healthy group,the motor conduction velocity and muscle action potential level of the median nerve motor conduction in the CTS group were lower,and the distal latency level was higher than that in the healthy group(P<0.05).Compared with the healthy group,the sensory conduction velocity and sensory nerve motor potential level of the median nerve sensory conduction in the CTS group were lower,and the latency difference level between the median nerve and the ulnar nerve was higher than that in the healthy group(P<0.05).Compared with the healthy group,the CSA,△-CSA,and R-CSA levels of the CTS group were higher(P<0.05).The sensitivity of EMG,high-frequency ultrasound,and EMG+high-frequency ultrasound in diagnosing CTS was 82.61%,77.42%,and 91.40%,respectively,the specificity was 88.57%,82.86%,and 94.29%,and the accuracy was 79.57%,76.34%,and 93.55%,respectively.The sensitivity,specificity,and accuracy of EMG+high-frequency ultrasound diagnosis were higher than those o

关 键 词：神经肌电图检查 高频超声 腕管综合征 价值 

分 类 号：R745[医药卫生—神经病学与精神病学]