先天性马蹄内翻足的神经肌肉功能的电生理学评价

目的:评价先天性马蹄内翻足(CTE)患儿神经及肌肉功能,并对其进行病因学探讨。方法:检测63例CTE患儿(86足)胫神经体感诱发电位(SEP)、胫神经H反射、下肢神经神经传导速度及肌电图,以了解CTE患儿的神经肌肉功能。结果:SEP异常率在轻、中、重CTE患儿组分别为6％、46％、64％。H反射异常率在中、重组分别为20％、24％。下肢周围神经传导及肌电图异常率在畸形程度的轻、中、重组分别为11％、9％、15％。确认病变位点在腰骶脊髓水平以上者33例(38％)。总异常率经卡方(X2)检验,与轻度组比较,中度组P<0．05;重度组P<0．01,差异有显著意义。结论:CTE存在神经肌肉功能异常,异常程度与畸形程度相关。

Evaluation of the neuromuscular function in congenital talipes equinovarus

Objective: To evaluate the neuromuscular function of congenital talipes equinovarus (CTE) in children. Methods: A total of 63 patients(86 feet) were investigated by somatosensory evoked potentials(SEP) after tibial nerve stimulation, H-reflex of tibial nerve, nerve conduction velocity(NCV) and electromyogram of the lower limb in order to explore the neuromuscular function of CTE in children. Results: The abnormality rate of SEP was 6% in mild group,46% in medium group and 64% in severe group,respectively. Meanwhile,the abnormality rate of H-reflex was 20% in medium group and 24% in severe group,respectively; the abnormality rate of NCV and EMG was 11% in mild group,9% in medium group and 15% in severe group,respectively. The pathological sites of 38% the clubfeet were localized above lumbarsacral region. Compared with the mild group,the overall abnormality rate increased significantly in medium group(P<0. 05)as well as in severe group(P<0. 01). Conclusions: Talipes equinovarus has abnormality of neuromuscular function. It was relative to the severity of deformity in clubfeet.