尺神經(jīng)肘部病變患者的神經(jīng)電生理定位診斷特征

《尺神經(jīng)肘部病變患者的神經(jīng)電生理定位診斷特征》由會員上傳分享，免費在線閱讀，更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫。

1、尺神經(jīng)肘部病變患者的神經(jīng)電生理定位診斷特征【摘要】目的探討神經(jīng)電生理檢查對尺神經(jīng)肘部損害患者的定位診斷價值。方法應(yīng)用常規(guī)的神經(jīng)電生理檢測法：包括尺神經(jīng)運動傳導(dǎo)、尺神經(jīng)小指腕感覺神經(jīng)傳導(dǎo)、尺神經(jīng)支配肌肉的肌電圖；特殊檢測法：短節(jié)段性神經(jīng)傳導(dǎo)檢測法，共檢測了21例經(jīng)臨床診斷并進(jìn)一步做神經(jīng)電生理檢查以確診尺神經(jīng)肘部病變的患者，與同期30例正常對照組進(jìn)行比較。短節(jié)段性神經(jīng)傳導(dǎo)檢測法重點檢測尺神經(jīng)運動傳導(dǎo)肘上至肘下段，以尋找其具體損害部位。結(jié)果①尺神經(jīng)病變組中有19例出現(xiàn)尺神經(jīng)在肘上至肘下段運動神經(jīng)傳導(dǎo)速度減慢；②尺神經(jīng)肘上至肘下

2、段短節(jié)段性神經(jīng)傳導(dǎo)檢測結(jié)果顯示具體病變部位多數(shù)集中在肱骨內(nèi)上髁上下2-3cm內(nèi)；③尺神經(jīng)在肘部病變者并非均有尺側(cè)腕屈肌肌電圖的異常。結(jié)論短節(jié)段性神經(jīng)傳導(dǎo)檢測法在確定尺神經(jīng)在肘部的具體損害部位時有較高的定位診斷價值，而常規(guī)的尺神經(jīng)感覺傳導(dǎo)及肌電圖異常能協(xié)助診斷。【關(guān)鍵詞】尺神經(jīng)病變；傳導(dǎo)阻滯；短節(jié)段性神經(jīng)傳導(dǎo)檢測法；肘上至肘下；肌電圖　　Theelectrophysiologicalfeaturesforlocalizing　ulnarneuropathyattheelbow12　　ABSTRACT:ObjectiveToe

3、xplorethediagnosticvaluesofelectrophysiologicalstudiesinlocalizingulnarneuropathyattheelbow.MethodsTotally21patientssuspectedwithulnarneuropathyattheelbowclinicallyunderwentroutineelectrodiagnostictestsfortheconfirmativediagnosis,andcontrastedwith30healthysubjects

4、.Routineelectrodiagnostictestsincludedulnarmotornerveconduction,ulnarsensorynerveconductionfromdigit5towrist,ulnarinnervatedmuscleelectromyography,andaspecialtest:shortsegmentnerveconductionstudy.Inordertolocalizeulnarneuropathyattheelbow,specialattentionwasfocus

5、edonulnarmotornerveconductionacrosstheelbowusingshortsegmentnerveconductionstudy.Results①Nineteenpatientswerefoundulnarmotornerveconductionslowingacrosstheelbow.②Shortsegmentulnarnerveconductionstudiesshowedthatmostofthelesionswerelocatedaboveorbelowthemedialepi

6、condyle2-3cm.③Abnormalflexorcarpiulnarismuscleelectromyographywasnotfoundinvolvedinulnarneuropathyattheelbow.ConclusionShortsegmentnerveconductionstudieshaveahighdiagnosticvalueinidentifyingthesiteoflesioninulnarneuropathyattheelbow,andabnormalulnardigit5towrists

7、ensorynerveconductionandabnormalelectromyographyfindingmayaidin12diagnosis.　　KEYWORDS:ulnarneuropathy;conductionblock;shortsegmentnerveconductionstudy;acrosstheelbow;electromyography　　尺神經(jīng)病變是常見的單神經(jīng)病，其發(fā)病率僅次于腕管綜合征，而損害的部位最常見的是在肘部。它可造成手指精細(xì)運動功能障礙，影響勞動及生活，神經(jīng)電生理檢查對其診斷和定位

8、起著任何其他檢查不可替代的作用，可以早期診斷，指導(dǎo)有效治療，尤其對需要手術(shù)治療者，能提供具體的損害部位。既往的研究多采用傳統(tǒng)的神經(jīng)電生理檢查，它不能準(zhǔn)確地確定尺神經(jīng)在肘部的具體損害部位。近年來，國外的多項研究[13]采用了在常規(guī)的神經(jīng)電生理檢查的基礎(chǔ)上加用肘上至肘下段短節(jié)段性神經(jīng)傳導(dǎo)檢測法以確定尺神經(jīng)