电生理定位结合术中神经监测在肘管综合征治疗中的应用

目的 探讨神经电生理定位诊断、术中监测在肘管综合征(CTs)中的应用.方法 55名尺神经松解前置术治疗CTs患者,术前用短节段位移法定位病变部位,术中监测尺神经传导速度(NCV)、潜伏期、波幅变化并对卡压组织行病理检查.结果 短节段位移法定位正确率83.64%;87.26%卡压组织为透明变性的韧带样组织;卡压组织切除后,NCV增快(t=14.15,P＜0.01),潜伏期缩短(t=-14.10,P＜0.01),波幅变化差异无统计学意义(t=0.114,P＞0.05);神经外膜切开后各指标变化差异均无统计学意义(P＞0.05).结论 神经电生理短节段位移法可较准确定位CTs病变;神经外膜松解术治疗CTs短期疗效不显著.

Study on the application of electroneurophysiology position oriented diagnosis and Intraoperative monitoring in the treatment of cubital tunnel syndrome

Objective Dicussing the application of electroneurophysiolagy position oriented diag-nosis and Intraoperative monitoring in the treatment of cubital tunnel syndrome (CTs). Methods 55 in-patients with CTs treated by ulnar nerve anterior transposition were enrolled, Intraoperative ulnar nerve conduction velocity(NCV), latent period and amplitude were recorded, electroneurophysiology position ori-ented diagnosis and pathology exam were also used. Results Accuracy rate of entrapment positioning by position oriented diagnosis is 83.64%, most of compressing agents (87.26%) are hyaline degeneration of ligaments;NCV is increased (t = 14.15 ,P ＜ 0.01) while latent period is shorten after compressing agent excision (t = -14.10, P ＜ 0. 01) ;electroneurophysiology indices have no significant change after epineuri-um dissection (P ＞ 0.05). Conclusion Electroneurophysiology position oriented diagnosis can locate the diseased region of CTs ;the short term effectiveness of epineurium dissection is not remarkable.