神经电生理联合超声检查在肘部尺神经卡压损伤中的应用

目的探讨神经电生理检测联合高频超声检查对肘部尺神经卡压损伤的综合评定价值。方法对32例肘部尺神经卡压患者(患侧为患肢组,健侧为健肢组)及16例正常对照组(32个肢体)进行尺神经神经电生理及高频超声检查。对比分析三组神经电生理数据,并将患肢组的肘上-肘下段运动传导速度(MCV)与高频超声测得尺神经的最大横截面积(CSA)进行相关性研究。结果神经电生理检查发现患肢组的肘上-肘下尺神经运动传导速度减慢,平均运动传导速度为29.31m.s-1,运动诱发波幅降低,与健肢组及正常对照组相比差异有统计学意义(P<0.01);高频超声检查患肢组肘管占位20例,周围组织黏连5例,组织增生4例,部分断裂1例,CSA的平均值为14.6mm×14.6mm;患肢组的肘上-肘下段MCV与CSA变化呈明显的负相关,相关系数为-0.813。结论神经电生理学检查是诊断肘部尺神经卡压的有效手段,联合高频超声检查能够提高肘部尺神经卡压的定位诊断准确率。

The Application of the Neural-electrophysiological Test Combined with the High-frequency Ultrasound Test on the Ulnar Nerve Entrapment Syndrome

Objective To explore the comprehensive assessment value of using the Neural-electrophysiological test and the high-frequency ultrasound in detecting the patients with ulnar nerve entrapment at the elbow(UNE).Methods 32 patients with ulnar nerve entrapment syndrome(the affected side were listed as the disease limb group and the contralateral side were listed as the healthy limb group) and 16 normal controls had participated in the clinical test,and all of them were tested by the Neural-electrophysiological test and the High-frequency ultrasound.A comparative analysis was conducted among the acquired data of the Neural-electrophysiological tests,and a correlation analysis between the elbow upper-elbow lower’s movement conduction velocities(MCV) acquired from the disease limb group and the biggest cross-sectional area(CSA) of ulnar nerve tested by the high-frequency ultrasound was conducted.Results The Neural-electrophysiological tests showed that the disease limb group’s MCV of the ulnar nerve with elbow upper-elbow lower reduced with it’s average mean 29.31 m·s-1,and the motor evoked volatility decreased too.Compared with the healthy limb group and the control group,the differences were statistically significant(P<0.05).The high-frequency ultrasound test showed that,among 32 patients,20 patients suffered with the cubital tunnel placeholders,5 patients with the surrounding tissue adhesion,4 patients with the tissue proliferation and 1 with the partial fracture.The average CSA was 14.6mm2 and it showed an significantly negative correlation compared with the change of the elbow upper-elbow lower’s MCV.The correlation coefficient was-0.813.Conclusion The neural-electrophysiological test is an effective measure to diagnose the ulnar nerve entrapment syndrome,and it united with the high-frequency ultrasound test can improve the accuracy of diagnostic localization of the syndrome.