正中神经掌支肌电图检测在腕管综合征诊断中的应用

目的: 通过对腕管综合征(CTS)患者进行正中神经掌支纤维(PCBm)肌电图检测及常规神经传导检测(NCS),探讨CTS患者PCBm的电生理异常,阐明PCBm肌电图检测在CTS诊断中的作用。方法: 通过临床表现及肌电图检测确诊为CTS的50例患者为CTS组,并以30名健康者为健康对照组,对所有研究对象行NCS检测。记录正中神经腕复合肌肉动作电位(CMAP)波幅(Amp)、远端潜伏期(Lat)、运动传导速度(MCV);记录指₃感觉神经动作电位(SNAP)Amp、Lat、感觉传导速度(SCV),同时进行PCBm肌电图检测,观察各项指标的变化。结果: 与健康对照组比较,CTS患者(100%)均出现正中神经传导检测异常,主要表现为CMAP远端Lat延长(P<0.01),指3 SCV减慢及Lat延长(P<0.01),显示为正中神经腕部损伤;其中20例(29只手,45.3%)患者PCBm SCV减慢(P<0.01),Lat延长(P<0.01),提示PCBm损伤。结论: CTS患者常出现PCBm损伤,PCBm损伤可作为传统CTS神经电生理检测的补充,可做为CTS超出腕部损伤的依据。

Application of electromyogram of palmar cutaneous brahch of median nerve in dignosis of carpal tunnel syndrome

Objective To analyze the electrophysiological changes of palmar cutaneous brahch of median nerve (PCBm) in the patients with carpal tunnel syndrome(CTS) by detecting the electromyogram of PCBm and routine nerve conduction studies (NCS) of the CTS patients. Methods 50 patients who were diagnosed as CTS according to clinical features and electromyogram were used as CTS group and 30 cases of healthy persons were used as healthy control group.NCS were performed in all subjects.The complex muscle action potentials (CMAP) amplitude (Amp),distal latencies (Lat),motor conductive velocities (MCV),sensory nerve action potentials (SNAP) Amp,distal latencies (Lat)and sensory conductive velocities (SCV) were recorded,and the electromyogram of PCBm was performed. Results Compared with healthy control group, abnormal NCS of median nerve was found in all patients with CTS (100%),and the most common abnormal features were prolonged CMAP distal Lat and digits 3 Lat(P<0.01),and lower SCV of digits 3(P<0.01).29 (45.3%) patients had PCBm involvement,mainly exhibited as prolonged Lat(P<0.01), and lower SCV(P<0.01). Conclusion PCBm injury is commonly seen in the patients CTS,NCS of PCBm should be performed in the patients with CTS,and it should be considered as a definition that the compression of median nerve is beyond the carpal tunnel.