47例腕管综合征患者的临床及神经电生理改变特征

目的：分析腕管综合征（CTS）患者临床及神经电生理改变特征，以提高临床诊断准确性。方法：对47例临床症状、体征均符合CTS患者的正中神经和尺神经各55条分别进行运动神经传导速度（MCV）和感觉神经传导速度（SCV）测定，其结果与正常参考值作比较；对拇短展肌和某些病例的掌长肌作针极肌电图（EMG），观察失神经电位以作鉴别诊断。结果：本组正中神经肘-腕MCV有6条未引出动作电位，41条正常，8条减慢，平均MCV较正常参考值减慢，差异有显著意义（P％0．05）；正中神经远端潜伏期（DML）异常率为96％，平均DML较正常参考值延长，经比较差异有显著意义（P〈0．05）；尺神经肘-腕MCV均在正常范围，其DML异常率为2％，与正常参考值比较差异无统计学意义；正中神经SCV异常率为98％；尺神经SCV异常率为2％；47例共55块拇短展肌EMG有49％见失神经电位。结论：结合临床及神经电生理改变特点，可对CTS作出明确诊断，为治疗提供依据。

The characteristics of clinical and electro neurophysiological changes with patients in 47 with patients carpal tunnel syndrome

Objective：To analyze the characteristics of clinical and eletro neurophysiological changes in patients carpal tunnel syndrome （CTS）, so as to increase the accuracy of clinical diagnosis. Methods： 47 Forty seven patients with carpal tunnel syndrome who had definite clinical and physical signs were selected in the present study. Motor conduction velocities （MCV） and sensory conduction velocities （SCV） were measured in 55 medial nerves and 55 ulnar nerves. The results were compared with normal reference value. Then EMG was measured in abductor pollicis brevis and palmaris longus to observe denervation potentials. Results： The elbow-wrist MCV of medial nerves： not induced in 6 nerves, normal in 41 nerves, slow in 8 nerves. The average MCV of medial nerves was significantly down slow from the normal reference value （P 〈 0.05）. The abnormality rate of medial nerve DML was 96 %, and the average DML was significantly lengthened from the normal reference value （P〈 0.05） ; elbow-wrist MCV of ulnar nerves was normal in all nerves, and the abnormality rate of DML was 2%, and the average DML was not significantly different from the normal reference value; the abnormality rate of SCV in medial in the patients and ulnar nerve was 98% and 2% respectively. The denervation potentials were found in 49% abductor pollicis brevis （55 muscles of 47 patients）. Conclusion： The characteristics of clinical and electro neurophysiological changes provide useful evidence for CTS diagnosis and treatment.