重症腕管综合征的神经电生理诊断

目的：探讨重症腕管综合征（CTS）的神经电生理诊断价值。方法：回顾性分析了常规神经电生理检查正中神经运动和感觉传导均未诱发出电位即重症CTS者38例（44只手），分别在正中神经和尺神经手腕处刺激，在第二蚓状肌和手掌骨间肌记录混合肌肉动作电位（CMAP）起始潜伏时差。结果：重症CTS44只手中，40只手（91％）在正中神经和尺神经刺激时，第二蚓状肌和手掌骨间肌记录CMAP起始潜伏时差延长，与正常对照组对比，其差异有统计学意义，4只手第二蚓状肌记录未引出波形；拇短展肌肌电图全部异常。结论：第二蚓状肌和手掌骨间肌记录CMAP起始潜伏时差测定是一项快速、简单而准确的诊断重症CTS的神经电生理检查方法。

The electrophysiologicai diagnosis for severe carpal tunnel syndrome.

Objective： To explore the diagnostic value of electrophysiological detection for severe carpal tunnel syndrome（CTS）. Methods： Thirty-eight patients（44 bands）with severe CTS were examined in associated absent median motor and sensory responses on routine nerve conduction, and the compound muscle action potential（CMP） latency difference recorded from the second lumbrical-palmar intherossei muscle was analyzed. Results： Forty out of 44 hands with CTS （91%）showed significant prolongation of the second lumbrical-palmar interossei latency difference, compared with normal values. The remaining 4 hands had absent median motor CMAPs recorded from second lumhrieal muscles. All the patients had abnormal EMG in abductor pollicis brevis muscles. Conclusion： The examintion of the second lumbrical-palmar interossei latency difference is a valuable electrodiagnostic technique in diagnosing severe CTS, especially when associated with absent routine median motor and sensory responses.