肌电图-神经电图测定健侧颈_7神经根移位桥接至受体神经后再生的临床研究

目的　用肌电图 -神经电图检测方法 ,研究健侧颈 7神经根移位通过桥接至受体神经后再生的状况。方法　 1996年 3月至 1998年 9月 ,对 2 8例健侧颈 7移位二期手术后患者 ,定期进行肌电图 -神经电图随访。术后随访时间为 3～ 5 8个月 ,平均 15 .4个月。分别在胸锁关节、胸腋部、腋部、肘部或外侧肌间隔刺激受体神经 (肌皮神经、桡神经和正中神经 ) ,于该神经支配的相应肌肉上记录复合肌肉动作电位 (CMAP) ,测定其潜伏期 (L at)、波幅 (Amp)。计算出动力神经纤维在受体神经的运动传导速度(MNCV) ,并观察其肌电图表现。结果　患侧桡、肌皮和正中神经支配的相应肌肉 ,分别在术后 4、6和 12个月时检测到神经再生电位。结论　健侧颈7神经根移位后 ,受体神经中出现再生电位最早的为肌皮神经 ,桡神经次之 ,正中神经最晚

Electrophysiological study on nerve regeneration after second stage contralateral C 7 transfer

Objective To determine nerve regeneration after second stage transfer of contralateral C 7 to the recipient nerves by means of electrophysiological examination. Methods From March 1996 to September 1998, electrophysiological examination was done periodically in 28 cases after second stage contralateral C 7 transfer to the musculocutaneous nerve, radial nerve,and median nerve. Electromyography(EMG) and compound muscle action potentials(CMAP) of the muscles innervated by the recipient nerves were examined during follow up period. The latency, amplitude and motor nerve conduction velocity(MNCV) were measured. To record CMAP, the stimulation electrodes were put at the sternoclavicular joint, thoracic axillary zone, axilla, radial groove or elbow respectivelly. All patients were followed for 3 to 58 months, with an average of 15.4 months. Results After second stage contralateral C 7 transfer, nerve regeneration in the muscles innervated by the musculocutaneous, radial and median nerves could be first detected at postoperative month 4,6 and 12 respectively. Conclusions Among the recipient nerves after second stage contralateral C 7 transfer, regeneration potential was detected in the following order: musculocutaneous nerve, radial nerve,and median nerve.