术中神经电生理监测和刺激尺神经治疗肘管综合征

目的 评估尺神经松解前置术结合术中超强电刺激治疗肘管综合征的治疗效果.方法 30例中重度肘管综合征患者首先进行尺神经松解前置术,测定并记录松解后小指展肌复合肌肉动作电位(CMAP)的潜伏期及波幅;然后给予尺神经超强电刺激治疗(80 mA,2Hz,10 min),按照同样的方法再次记录小指展肌CMAP的潜伏期及波幅,并将刺激前后的数据进行统计学分析.结果 患者尺神经外膜松解后与超强电刺激后小指展肌CMAP的波幅分别为(2.5±0.4) mV和(6.2±0.8)mV,潜伏期分别为(12.0±0.6)ms和(10.3±0.3)ms,经比较有统计学意义(P＜0.05).超强电刺激后小指展肌CMAP的潜伏期较前平均缩短15.7％,波幅平均增大约2倍.结论 术中超强电刺激对肘管综合征患者的尺神经功能恢复具有辅助治疗作用.

Intraoperative monitoring and supramaximal stimulation on ulnar nerve for the treatment of cubital tunnel syndrome

Objective To evaluate the therapeutic effect of decompression and anterior transposition of ulnar nerve combined with intraoperative supramaximal stimulation.Methods A total of 30 patients diagnosed as cubital tunnel syndrome with moderate to severe damage were performed decompression and anterior transposition of ulnar nerve.The amplitude and latency period of compound muscle action potential（CMAP） of abductor digiti minimi muscle after decompression were measured and recorded.Then the ulnar nerve was treated with intraoperative supramaximal stimulation（80 mA,2 Hz,10 min）.The amplitude and latency period of CMAP of abductor digiti minimi muscle were also measured and recorded.The data before and after stimulation were analyzed by statistics.Results The amplitude of CMAP of abductor digiti minimi muscle after decompression and after supramaximal stimulation was（2.5±0.4） mV and（6.2±0.8） mV,respectively,while the latency period of CMAP was（12.0±0.6） ms and（10.3±0.3） ms,respectively.There was significant difference in amplitude and latency period before and after stimulation（P0.05）.The latency period of the CMAP of abductor digiti minimi muscle was shortened by 15.7% and the amplitude was doubled in average.Conclusion The use of intraoperative monitoring and supramaximal stimulation has the auxiliary therapeutic effect on the recovery of ulnar nerve in cubital tunnel syndrome.