神经电生理检测对腕管综合征临床诊断的意义

目的探讨神经电生理检测对诊断腕管综合征(CTS)的临床意义。方法对42例(74侧)CTS患者正中神经的神经电位、传导速度测定,拇短展肌、小指展肌肌电图(EMG)检查,并与30例(60侧)正常者对比分析。结果42例(74侧)CTS患者做神经电生理检测,正中神经感觉传导异常100%,其中感觉传导速度(SCV)减慢85.1%,感觉电位潜伏期(DSL)延长89.2%,感觉电位波幅(SNAP)降低24.3%,感觉动作电位未引出4侧;正中神经运动传导异常97.3%,其中运动传导速度(MCV)减慢5.4%,运动末端潜伏期(DML)延长83.8%,运动电位波幅(CMAP)降低20.3%,运动动作电位未引出3侧。CTS组患者正中神经SCV、DSL、SNAP、DML、CAMP与对照组比较,差异有统计意义(P0.05)。CTS组74块拇短展肌57块(77.0%)呈神经源性损害改变。结论神经电生理检测对早期诊断CTS、确定正中神经的损伤程度具有重要价值,是临床诊断CTS的重要手段。     

神经传导速度差异规律量化评估肌萎缩侧索硬化症

背景肌电图的神经传导速度异常是肌萎缩侧索硬化( amyotrophic lateral sclerosis,ALS)的诊断标准之一,可否以其变化差异规律来量化患者病情变化和评估预后? 目的研究肌萎缩侧索硬化 (amyotrophic lateral sclerosis,ALS)患者中神经传导速度的改变,建立量化评定肌萎缩侧索硬化病情及其预后的神经生理指数. 设计回顾性分析. 地点和对象本研究的地点为北京大学第三医院神经科,研究对象为北京大学第三医院神经内科 1997-02/1999-03住院患者. 方法对 21名 ALS患者的 30条尺神经、 32条正中神经及 24名健康对照组的 38条尺神经、 40条正中神经进行运动传导速度 (motor conduction velocity, MCV)及感觉传导速度( sensory conduction velocity, SCV)和 F波进行检测.两组间数据进行统计学分析. 主要观察指标两组正中神经神经传导速度与 F波, ALS组患者小指展肌的肌力与 CMAP波幅 /DML× F出现率数值的相关性. 结果 ALS组正中神经、尺神经运动传导速度的远端潜伏期 (distal motor latency, DML)、肌肉动作电位( compound muscle action potential, CMAP)波幅及面积、 F波的出现率较对照组有显著性差异.而两组 MCV、 SCV、 F波的潜伏期差异无显著性. ALS组中 10名小指展肌的肌力与 CMAP波幅 /DML× F出现率的数值有显著的相关性 (r=0.89,P< 0.01). 结论 CMAP波幅 /DML× F波的出现率是一种有效的客观的电生理指数,可对 ALS病情及其预后进行量化评估.     

神经传导速度差异规律量化评估肌萎缩侧索硬化症

背景：肌电图的神经传导速度异常是肌萎缩侧索硬化(amyotrophic lat-eral sclerosis，ALS)的诊断标准之一，可否以其变化差异规律来量化患者病情变化和评估预后?目的：研究肌萎缩侧索硬化(ammyotrophic lateral sclerosis，ALS)患者中神经传导速度的改变，建立量化评定肌萎缩侧索硬化病情及其预后的神经生理指数。设计：回顾性分析。地点和对象：本研究的地点为北京大学第三医院神经科，研究对象为北京大学第三医院神经内科1997—02／1999—03住院患者。方法：对21名ALS患者的30条尺神经、32条正中神经及24名健康对照组的38条尺神经、40条正中神经进行运动传导速度(motor conduc-tion velocity，MCV)及感觉传导速度(sensory conduction velocity，SCV)和F波进行检测。两组间数据进行统计学分析。主要观察指标：两组正中神经神经传导速度与F波，ALS组患者小指暖肌的肌力与CMAP波幅／DML&;#215;F出现率数值的相关性。结果：ALS组正中神经、尺神经运动传导速度的远端潜伏期(distal molor latency，DML)、肌肉动作电位(compound muscle action potential，CMAP)波幅及面积、F波的出现率较对照组有显著性差异。而两组MCV、SCV、F波的潜伏期差异无显著性。ALS组中10名小指展肌的肌力与CMAP波幅／DML&;#215;F出现率的数值有显著的相关性（r=0．89，P&;lt;0．01）。结论：CMAP波幅／DML&;#215;F波的出现率是一种有效的客观的电生理指数，可对ALS病情及其预后进行量化评估。     

47例腕管综合症患者的神经传导检测分析

目的探讨腕管综合症（CTS）患者神经传导检测特征。方法对临床症状、体征符合CTS的47例行正中神经、尺神经的运动及感觉神经传导检测。结果47例cTs患者中女性占76．6％,其中共有82侧腕管神经出现病变,双侧病变占74．5％。82侧腕正中神经指3-腕感觉潜伏期、SCV、感觉诱发波幅及DML与正常参考值相比较,差异有统计学意义。结论神经传导检测对CTS诊断有重要意义。     

腕管综合征279例神经电生理分析

目的探讨电生理检查指标在腕管综合征(CTS)诊断中的应用价值。方法以CTS患者279例为观察组,健康志愿者228例为对照组,行神经电生理检测。结果两组末梢运动潜伏期(DML)、复合肌肉动作电位(CMAP)波幅、前臂段运动传导速度(f MCV)、感觉神经动作电位(SNAP)波幅及腕-食指感觉传导速度(SCV)比较,差异均有统计学意义(P0.05);尺神经电生理指标间差异均无统计学意义(P0.05)。结论 CTS的诊断需要结合多项电生理检查指标以减少疾病的漏诊。     

神经松动术联合甲钴胺治疗轻中度腕管综合征的临床疗效及电生理观察

目的观察神经松动术联合甲钴胺治疗轻、中度腕管综合征（CTS）的疗效。 方法采用随机数字表法将60例早期CTS患者分为对照组及神经松动组。对照组单纯给予甲钴胺口服治疗,神经松动组在甲钴胺治疗基础上辅以神经松动术治疗。于治疗前、治疗2周、治疗4周后分别采用视觉模拟评分（VAS）、整体症状评分（GSS）对2组患者疗效进行评定,同时于上述时间点对2组患者腕部正中神经进行电生理检查,检查指标包括正中神经远端潜伏期（DML）、拇指-腕及中指-腕感觉传导速度(SCV)、拇指-腕和中指-腕感觉神经动作电位波幅（SNAP）、正中神经复合动作电位波幅（CMAP）及正中神经运动传导速度(MCV)等。 结果治疗2周及治疗4周后,神经松动组患者疼痛VAS评分［分别（3.95±1.87）分、（3.29±1.51）分］、GSS评分［分别为（14.63±4.76）分、（11.62±4.21）分］、正中神经电生理检查结果均较治疗前明显改善（P<0.05）;治疗2周后神经松动组患者疼痛VAS评分较对照组明显改善（P<0.05）;治疗4周后神经松动组患者GSS评分及正中神经各项电生理指标均显著优于对照组水平（P<0.05）。 结论神经松动术联合甲钴胺治疗轻、中度CTS患者的疗效显著优于单纯甲钴胺口服治疗,电生理检查能客观评价神经松动术治疗轻、中度CTS患者的临床疗效。     

80例腕管综合征患者的神经电生理测定

目的：观察神经电生理检测对腕管综合征(CTS)的诊断敏感性。方法：80例临床提示为CTS或不能除外CTS的患者进行神经电生理测定并进行回顾性分析。结果：80例116侧正中神经复合肌肉动作电位末端运动潜伏期和波幅、肘至腕的运动传导速度、指至腕部的感觉传导速度及感觉神经动作电位波幅等5项指标检测异常率分别为75．0％、19．8％、9．5％、88．8％及37．9％；45例65侧拇指正中／桡浅神经潜伏期差(MRLD)及环指正中／尺神经潜伏期差(MULD)检测异常率95．4％。结论：正中神经拇指至腕段的感觉传导速度测定是诊断CTS的敏感指标，采用MRLD及MULD测定，诊断敏感性更高。     

电针联合神经肌腱滑行训练治疗轻中度腕管综合征的疗效观察

目的观察电针联合神经肌腱滑行训练治疗轻中度腕管综合征(CTS)的临床疗效。 方法采用随机数字表法将40例轻中度CTS患者分为观察组及对照组。2组患者均常规口服神经营养药物,观察组患者在上述基础上辅以电针及神经肌腱滑行训练,对照组则辅以CTS健康教育宣教。于治疗前、治疗4周后分别采用视觉模拟评分（VAS）、波士顿腕管量表(BCTQ)评定2组患者临床疗效,同时对比分析其电生理指标变化情况,包括拇指-腕及中指-腕感觉传导速度（SCV）、拇指-腕和中指-腕感觉神经动作电位波幅（SNAP）、正中神经远端潜伏期(DML)及拇短展肌复合动作电位波幅（CAMP）等。 结果治疗前2组患者各项电生理指标（包括拇指-腕和中指-腕SCV、SNAP、正中神经DML及拇短展肌CMAP）、疼痛VAS及BCTQ评分组间差异均无统计学意义（P>0.05）;分别经4周治疗后发现观察组拇指-腕SCV［(45.77±6.24)m/s］、中指-腕SCV［(49.15±8.26)m/s］、拇指-腕SNAP［(13.48±4.21)μV］、中指-腕SNAP［(12.83±4.37)μV］、正中神经DML［(3.58±1.02)ms］、拇短展肌CMAP［(8.78±2.98)mV］、疼痛VAS评分［（2.80±1.01）分］均较治疗前及对照组明显改善（均P<0.05）;观察组治疗后BCTQ症状评分［（1.99±0.81）分］、功能评分［（1.62±0.74）分］均较治疗前明显下降（P<0.05）;对照组仅发现正中神经DML［(4.34±1.08)ms］、拇指-腕SCV［(40.24±6.76)m/s］及疼痛VAS评分［（3.67±1.11）分］较治疗前明显改善（P<0.05）。 结论电针联合神经肌腱滑行训练能显著改善轻中度CTS患者手功能及临床症状,该联合疗法值得临床推广、应用。     

神经松动术联合体外冲击波治疗轻中度腕管综合征的疗效观察

目的 观察神经松动术联合体外冲击波治疗腕管综合征（CTS）的临床疗效。 方法 采用随机数字表法将56例轻中度CTS患者分为观察组及对照组,每组28例。2组患者均常规给予甲钴胺口服,对照组在此基础上对患侧腕部行正中神经松动术,每天治疗10 min,每周治疗6 d;观察组在对照组干预基础上辅以体外冲击波治疗,每次治疗总冲击次数为2000次,功率密度为0.16 mJ/mm2,每天治疗1次,每周治疗3 d。于治疗前、治疗2周、4周后分别采用整体症状评分（GSS）、视觉模拟评分法（VAS）对2组患者进行疗效评定,同时对患者腕部正中神经进行电生理检查,检查指标包括拇指-腕及中指-腕感觉传导速度（SCV）、感觉神经动作电位（SNAP）、拇短展肌复合动作电位（CMAP)、正中神经远端潜伏期（DML）及运动传导速度（MCV）等。 结果 治疗2周及4周后,发现2组患者GSS及疼痛VAS评分均较治疗前明显改善（P<0.05）;并且上述时间点观察组GSS评分［分别为（13.12±4.55）分和（7.56±5.01）分］及疼痛VAS评分［分别为（3.32±1.66）分和（1.22±1.08）分］亦显著优于对照组水平（P<0.05）;治疗4周后观察组正中神经DML［（3.65±0.73）ms］、拇指-腕SCV［（45.12±5.56）m/s］、中指-腕SCV［（55.45±7.67）m/s］、拇短展肌CMAP［（8.23±3.15）mV］、拇指-腕SNAP［（13.21±4.23）μV］及中指-腕SNAP［（13.45±3.89）μV］均较治疗前及治疗2周时明显改善（P<0.05）;对照组仅有正中神经DML［（3.68±0.77）ms］较治疗前及治疗2周时明显改善（P<0.05）,拇指-腕SNAP［（10.78±4.34）μV］较治疗前明显改善（P<0.05）;治疗4周后观察组上述各项电生理指标结果均显著优于对照组（P<0.05）。 结论 神经松动术联合体外冲击波治疗CTS具有协同作用,能进一步缓解患者疼痛,增强腕部功能,该联合疗法值得临床推广、应用。     

手掌混合神经电位潜伏时差诊断轻度腕管综合征的价值

目的：分析正中及尺神经手掌一腕混合神经电位潜伏时差在诊断轻度腕管综合征的价值。 方法：回顾性分析经新加坡国家脑神经科学院神经内科门诊神经内科医生临床确诊且临床症状符合腕管综合征的62例患者的正中及尺神经掌-腕混合神经电位潜伏时差，并与同期52例正常对照组的各项神经传导检测结果进行比较。对照组与腕管综合征组患者均检测正中神经、尺神经运动及感觉传导。采用片状表面电极记录运动传导末端潜伏时；采用反向法检测正中神经腕-示指感觉神经电位，主要观察感觉神经电位潜伏时；用顺向法检测正中及尺神经手掌混合神经传导，观察正中神经及尺神经混合神经电位潜伏时差。正中神经运动传导末端潜伏时、腕-示指感觉神经传导电位潜伏时、手掌正中及尺神经混合神经电位混合神经电位潜伏时差大于本实验室同期所做的52例对照组的正常参考值x^-&;#177;1．96s为延长。 结果：腕管综合征患者62例及对照组52人均采集到各项指标，全部进入结果分析。①腕管综合征组患者正中神经运动传导末端潜伏时、腕-示指感觉神经电位潜伏时均与对照组接近，差异无显著性意义（P值分别为0．494和0．144）。②腕管综合征组患者正中及尺神经手掌-腕混合神经电位潜伏时差与对照组比较明显延长，差异有显著性意义[（2．078&;#177;0．316），（1．706&;#177;0．121）ms，t=8．998，P=0．000]。③当正中及尺神经手掌-腕混合神经电位潜伏时差大于对照组x^-&;#177;1．96s时为延长，可得到正常值上限为0．398ms，腕管综合征组患者中此潜伏时差〉0．398ms者55例，占88．7％，即采用正中及尺神经手掌-腕混合神经电位潜伏时差明显的提高了腕管综合征的诊断率，但仍有7例（11．3％）腕管综合征患者其正中及尺神经手掌-腕混合神经电位潜伏时差在0．4ms以内。 结论：正中及尺神经手掌-腕混合神经电位潜伏时差在诊断轻度腕管综合征时具有较高的诊断价值。     

Electrodiagnosis of mild carpal tunnel syndrome

Electrophysiologic tests have been reported to detect mild carpal tunnel syndrome (CTS). Such tests include (i) absolute palmar latency of median wrist segment; (ii) comparison of median and radial distal sensory latencies in digit I; (iii) comparison of median and ulnar distal sensory latencies in digit IV; (iv) comparison of median and ulnar palmar latencies; (v) comparison of median and ulnar sensory potential amplitudes in digits II and V. To clarify the clinical utility of these tests, the parameters of all five tests were determined across four carefully established patient subgroups: group A, controls; group B, CTS referrals with normal nerve conduction studies (NCS) and normal needle electromyography (EMG); group C, CTS referrals with abnormal NCS and normal EMG; group D, CTS referrals with abnormal NCS and abnormal EMG. Special attention was focused on patients in group B who represent the diagnostic dilemma. In group B, tests ii and iii each yielded abnormal results in 44% of hands, while the combination of tests ii and iii yielded abnormal results in 51% of hands.     

Ulnar nerve involvement in carpal tunnel syndrome

This is a retrospective study of the involvement of the ulnar nerve in patients with electrodiagnostic evidence of carpal tunnel syndrome as defined by median sensory nerve action potential (SNAP) greater than 3.6msec at the wrist and/or motor distal latency in excess of 4.3msec. The study included 248 patients, 63 (25%) with unilateral and 185 (75%) with bilateral carpal tunnel syndrome. The electrodiagnostic criteria for ulnar nerve involvement was a SNAP peak latency greater than 3.7msec and/or motor distal latency in excess of 4.2msec. One hundred fourteen patients (46%) had delayed ulnar SNAP peak at the wrist; of these, 100 cases had bilateral ulnar nerve involvement and 14 had unilateral abnormalities. Slowing of the motor nerve conduction velocity for the elbow-wrist segment was noted in 24% and 15% of the study group for the median and ulnar nerves, respectively. An incidental finding was the presence of "double crush syndrome" in 35 patients (14%). The results of this study suggest the frequent association of ulnar nerve involvement at the wrist for sensory fibers and carpal tunnel syndrome.     

Extra-median spread of sensory symptoms in carpal tunnel syndrome suggests the presence of pain-related mechanisms

Patients with carpal tunnel syndrome (CTS) may complain of sensory symptoms outside the typical median nerve distribution. The study is aimed to understand which clinical features are associated with the extra-median distribution of symptoms in CTS. We recruited 241 consecutive CTS patients. After selection, 103 patients (165 hands) were included. The symptoms distribution was evaluated with a self-administered hand symptoms diagram. Patients underwent objective evaluation, neurographic study and a self-administered questionnaire on subjective complaints. No clinical or electrodiagnostic signs of ulnar nerve involvement were found in the 165 hands. Median distribution of symptoms was found in 60.6% of hands, glove distribution in 35.2% and ulnar distribution in 4.2%. Objective measures of median nerve lesion (tactile hypaesthesia and thenar muscles hypasthenia) and neurographic involvement were significantly more severe in median hands than in the other groups. Subjective complaints (nocturnal pain, numbness and tingling sensations) were significantly more severe in glove hands. Neurophysiological and objective measures were not correlated with subjective complaints. The severity of the objective examination and neurographic involvement and the intensity of sensory complaints appear to be independent factors that influence the symptoms distribution. Extra-median spread of sensory symptoms was associated with higher levels of pain and paresthesia. We suggest that central nervous system mechanisms of plasticity may underlie the spread of symptoms in CTS.     

Carpal tunnel syndrome in chronic renal dialysis patients

Pain, dysesthesias, sensory changes, and weakness in hands of uremic patients receiving renal dialysis are usually attributed to peripheral neuropathy or vascular steal syndrome. Our experience suggested superimposed carpal tunnel syndrome (CTS) as an additional etiology. This premise was studied by using electromyography and standardized electrodiagnostic techniques to measure median and ulnar conduction velocities and distal motor and sensory latencies. Of 48 patients tested, 15 (31%) had symptomatic CTS, confirmed by electrodiagnosis. Seven of these patients had bilateral CTS. Twelve patients subsequently had surgical flexor retinaculum release, resulting in relief of symptoms. Thirty-seven of the 48 patients tested, including all 15 with CTS, had peripheral neuropathy. Of the patients with peripheral neuropathy, and who were on dialysis longer than 5 years, 57% also had CTS. Slowing of ulnar nerve conduction velocity across the elbow was found in 11 arms, including 3 with CTS. The high incidence of CTS in this renal dialysis population appears to be related to nerve compression secondary to a thickened transverse carpal ligament. Increasing time on dialysis was related to an increased incidence of CTS. However, the presence of forearm access (AV fistula or cannula) was not crucial to the development of CTS. CTS is treatable and should be considered in the differential diagnosis of hand and arm symptoms in chronic dialysis patients.     

感觉神经传导检查比较法在诊断轻度腕管综合征中的应用

目的寻找诊断轻度腕管综合征（CTS）敏感的神经电生理指标。方法回顾性分析经吉林大学第一医院手外科医生临床诊断,并经手术治疗疗效确实,但常规电生理检查提示拇短展肌复合肌肉动作电位的潜伏期（CAMP）及示、中指感觉神经传导检查正常的患者80人,共92例手的腕管综合征患者进行神经电生理分析,采用顺向法记录掌腕正中、尺神经混合神经电位潜伏期时差和环指腕正中、尺神经感觉神经电位潜伏期时差,以潜伏期时差差值≥0．4ms为阳性指标,计算其阳性符合率,并进行统计学分析。结果掌腕正中、尺神经混合神经电位潜伏期时差≥0．4ms为64例,阳性率为69．56％;环指腕正中、尺神经感觉神经电位潜伏期时差≥0．4ms为83例,阳性率为90．21％。其中两种方法均为阳性的62例,均为阴性的7例。结论环指腕正中、尺神经感觉神经电位潜伏期时差在诊断轻度腕管综合征时具有较高的诊断价值。     

Repeatability of Nerve conduction Measurements using Automation

Objective

To quantify nerve conduction study (NCS) reproducibility utilizing an automated NCS system (NC-stat^®, NeuroMetrix, Inc.).

Method

Healthy volunteers without neuropathic symptoms participated in the study. Their median, ulnar, peroneal, and tibial nerves were tested twice (7 days apart) by the same technician with an NC-stat^® instrument. Pre-fabricated electrode arrays specific to each nerve were used. Both motor responses (compound motor action potential [CMAP] and F-waves –all nerves) and sensory responses (sensory nerve action potentials [SNAP] –median and ulnar nerves only) were recorded following supramaximal stimuli. Automated algorithms determined all NCS parameters: distal motor latency (DML), mean F-wave latency (FWL), distal sensory latency (DSL), CMAP amplitude, and SNAP amplitude. Latency was adjusted for skin temperature deviation from reference. Pearson correlation coefficient (CC), intraclass correlation coefficient (ICC), coefficient of variance (CoV), and relative intertrial variation (RIV) were calculated.

Results

Fifteen subjects participated in either upper or lower extremity studies with nine participating in both. With the exception of CMAP amplitude, all parameters had CoV less than 0.06. Upper extremity amplitude parameters had CCs greater than 0.85. CCs for latencies were greater than 0.80 except for the median nerve FWL (CC = 0.69). For lower extremity nerves, ICCs were highest for mean FWL (>0.90), followed by DML (>0.82) and then CMAP (peroneal 0.33, tibial 0.73). The 10th to 90th RIV percentiles were bounded by ±7% for F-wave latencies;?±9% for all DSLs; and?±11% for DML (except peroneal at 15%).

Conclusions

The reproducibility of NCS parameters obtained with an automated NCS instrument compared favorably with traditional electromyography laboratories. F-wave latencies had the highest repeatability, followed by DML, DSL, SNAP and CMAP amplitude. Given their high reproducibility, automated NCS instrument may encourage wider utilization of NCS in clinical and research applications.     

Carpal tunnel syndrome in patients on long-term hemodialysis

Sixteen cases with carpal tunnel syndrome (CTS) were reported out of 412 patients on long-term hemodialysis due to chronic renal failure. Clinical symptoms included numbness in the area innervated by the median nerve in 100% of symptomatic hands and pain in the wrist and hand in 81%. This pain usually became severer at night and during hemodialysis. Muscle atrophy was noted in 41% of the hands. Nerve conduction studies revealed prolonged distal sensory latency, slowed sensory nerve conduction velocity across the wrist and normal distal motor latency in 18%, prolonged distal motor latency in 51% and no response in motor or sensory stimulation in 31%. Evidence of denervation on electromyography was seen in 36% of the hands. Patients were conservatively treated avoiding daily activities precipitating the condition with volar wrist splint only at night in 18% and in 90% with steroid hormone injection in the carpal tunnel. Median nerve release was performed in 18% of the hands. Amyloid deposit was demonstrated in 3 of 4 operated hands. Although the relation between long-term hemodialysis and the occurrence of the amyloid deposition in the carpal tunnel has not been established, the present data along with other recent reports strongly indicate that amyloid deposit in the carpal tunnel on hemodialysis patients could be one of the most possible cause of CTS.     

Carpal tunnel syndrome in railroad workers.

OBJECTIVE: To determine, within a specific industry, if carpal tunnel syndrome (CTS) is associated with job classification or other personal risk factors. To determine if surgical intervention for the treatment of CTS is indicated on the basis of electrodiagnostic criteria. DESIGN: More than 2500 claimants who screened positive for CTS were subjected to a formal history, physical examination, and electrodiagnostic studies. A total of 900 subjects were randomly selected for this study. The presence of CTS was determined by a method of comparing median minus ulnar nerve distal latency differential (MUD). RESULTS: There was a statistically significant relationship between CTS and body mass index (P < 0.001), wrist index (P < 0.001), and age (P < 0.001). A total of 43.4% of the participants (391/900) and 38.6% of the wrists (694/1800) had either positive or borderline findings for CTS. There was no difference between the left and right hands. There was no association between job classification and the presence of CTS. Using MUD criteria, more than half of the participants presumed to have CTS did not meet the requirements for diagnosis. Applying the same MUD criteria to all surgical cases, the indication for surgery could not be determined in one-third of the cases (33%, 83/248). CONCLUSIONS: In the population claiming CTS caused by railroad occupations, there was a significant association between CTS and body mass index, age, and wrist index, but not job classification. More than half of the study group and one-third of the surgical subset had normal MUD data.     

高频超声在腕管综合征诊断中的应用探讨

【目的】探讨高频超声在诊断腕管综合征（CTS）中的应用价值,并进一步分析神经增粗与神经传导速度及病程的相关性,并证实高频超声在诊断CTS中的临床价值。【方法】对100例健康志愿者及63例经临床和电生理检查确诊的CST进行高频超声腕管内正中神经的检查,并记录神经的横截面积（CSA）,并作CSA与神经电生理及病程的相关性分析。【结果】对照组腕管内正中神经的CSA为（8．60±2．25）mm^2,CST组CSA为（15．61±4．60）mm^2,两组相比较有显著差异（P〈0．01）。CST组CSA与神经电生理（感觉传导速速）的相关系数为-0．74（P〈0．01）,与CTS病程的相关系数为0．79（P〈0．01）。【结论】高频超声在CTS的诊断有重要应用价值,其可作为CTS及周围神经检查新的形态学诊断方法。