肌电图在前臂正中神经卡压的诊断和鉴别诊断中的应用价值

目的:探讨肌电图检测在前臂正中神经卡压诊断和鉴别诊断中的应用价值.方法:回顾分析100例临床诊断并经手术证实的前臂正中神经的神经肌电图检查资料,分析其电生理阳性指标.其中腕管综合症(carpal tunnelsyndrome,CTS)75例,前骨间神经卡压综合征(anterior interosseous entrapment nerve syndrome,AINS) 12例,旋前园肌综合征(pronator teres syndrome,PTS)10例,正中神经返支卡压征(recurrent median nerve entrapment syndrome RMNES)3例.结果:肌电图检测发现CTS患者正中神经腕部潜伏期延长,腕部以下正中神经感觉神经动作电位异常；AINS患者正中神经感觉神经功能正常,拇短展肌EMG正常,前骨间神经支配肌有自发电位或潜伏期延长,波幅降低；PTS患者正中神经支配肘下肌有自发电位,前臂NCV减慢,波幅降低,正中神经干动作电位及感觉神经动作电位异常.正中神经返支卡压综合症仅拇短展肌有异常电位,掌部潜伏期延长,感觉神经功能正常.结论:肌电图技术在诊断和鉴别前臂正中神经卡压疾病中有重要价值.

THE VALUE APPLIED OF ELECTROMYOGRAM IN DIAGNOSIS OF MEDIAN NERVE ENTRAPMENT IN FOREARM

Objective： To explore the value applied of electromyologram （EMG） in diagnosis of the median nerve entrapment in forearm. Method： Electromyogram data of lO0 patients with medial nerve entrapment in forearm diagnosed clinically and confirmed during operation were studied retrospectively.They include 75 cases with carpal tunnel syndrome, 12 anterior interosseous entrapment nerve syndromes, 10 cases with pronator teres syndrome and 3 recurrent median nerve entrapment syndromes. Results： Electromyography study found that the prolonged latent period of median nerve in wrist and abnormal sensory nerve action potentials （ SNAP ） of media nerve below wrist in patient with CTS; in patient with anterior interosseous entrapment nerve syndrome, sensory function of median nerve and EMG of musculus abdactor hullucis brevis were normal. Spontaneous potential, prolonged latency period and declined amplitude in EMG were found in the dominate muscles of interosseous nervus. The presence of spontaneous potential in muscles below elbow dominated by median nerve and decreased nerve conduction velocity and amplitude in EMG in forearm were also found in patient with pronator teres syndrome, moreover, the action potential and sensory nerve action potential in median nerve trunk were abnormal .The abnormal potential of musclus abductor hullucis brevis and prolonged latency period in palma and normal sensory nerve function only presented in patient with recurrent median nerve entrapment syndrome. Conelusins： Electromyogram has an important clinical value in diagnosis and differential diagnosis of patients with median nerve entratrapmet in forearm.