早期腕管综合征的电生理指标比较

目的:分析诊断早期腕管综合征的电生理指标,比较其敏感性。方法:对临床诊断为早期腕管综合征、正中神经远端运动电位潜伏期(distal motor latency,DML)<4.5ms的患者50例60侧,测定正中神经、尺神经环指-腕的感觉神经动作电位(SNAP)潜伏期差值,正中神经、桡神经拇指-腕的SNAP潜伏期差值,以及正中神经节段检查两点间潜伏期差值,并对其结果进行比较分析。结果:正中神经、尺神经环指-腕的SNAP潜伏期差值异常(≥0.4ms)者58侧,达96.6%;正中神经、桡神经拇指-腕的SNAP潜伏期差值异常(≥0.4ms)者40侧,达80%;正中神经节段检查两点间潜伏期差值异常(≥0.4ms)者25侧,达41.6%。结论:正中神经、尺神经环指-腕的SNAP潜伏期差值异常是早期腕管综合征最敏感的指标。

THE COMPARISON OF ELECTROPHYSIOLOGICAL INDEX ON CARPAL TUNNEL SYNDROME IN EARLY STAGE

Objective： To analyse the electrophysiological index of early stage on carpal tunnel syndrome and compare their sensitivity. Methods：In 50 （ 60 sides ） patients with early carpal tunnel syndrome diagnosed clinically and DML 〈 4.5ms, the difference of sensory nerve action potential （ SNAP ） in the median and ulnar nerve in the ring finger, and the difference of SNAP in the median and radial nerve in the thumb finger , and the difference of DML in median nerve by inching test were detected. Then the results were analyzed.Results：The difference of SNAP in the median and ulnar nerve in the ring linger was abnormal （ ≥ 0.4ms ） in fifty-eight sides, for 96.6%. The difference of SNAP in the median and radial nerve in the thumb finger was abnormal （ ≥ 0.4ms ） in forty sides, for 80%. The difference of DML in median nerve by inching test was abnormal （ ≥ 0.4ms ） in twenty- five sides, for 41.6%. Conehtsion： The difference of latency of SNAP in the median and ulnar nerve in the ring finger is the most sensitive index for the early stage in carpal tunnel syndrome.