摘要
目的 探讨注射性坐骨神经损伤患者的电生理特点。方法 对 10 4例因肌肉注射引起坐骨神经损伤患儿的患肢腓总神经及胫神经或胫后神经的运动传导速度 (MCV)、末端运动潜伏期 (dML)、感觉传导速度 (SCV)和末端复合肌肉动作电位波幅 (dCMAPA)、感觉神经动作电位波幅 (SNAPA)等进行检测 ;同时检测坐骨神经支配肌针极肌电图 (EMG) ,以及 2 1例患儿双下肢H反射。结果 肌注后 2～ 7天已可检出多项电生理异常。腓总神经支的神经传导速度 (NCV)异常率 (6 8.0 % )明显高于胫神经支 (4 3.5 % ) (P <0 .0 5 )。腓总神经SCV、SNAPA和dML、dCMAPA异常程度与病期正相关 (r =0 .30 6 8,P <0 .0 0 5 ;r =0 .2 96 3,P <0 .0 0 5 ;r =0 3376 ,P <0 .0 0 1;r=0 .2 15 7,P <0 .0 5 )。 8个月以上病期的NCV值异常程度明显加重 (P <0 .0 5 )。腓总神经NCV各项配对t检验发现运动纤维dML和dCMAPA异常程度重于感觉纤维SCV和SNAPA(P <0 0 5 ,P <0 .0 0 1)。 11例 (5 2 .4 % )患儿H反射异常。结论 化学药物对神经髓鞘传导功能有直接损伤。坐骨神经运动纤维的电生理异常早于且重于感觉纤维。腓总神经运动传导功能检测是本病早期诊断的重要依据。 8个月以上病期的损伤神经恢复难度增加。
Objective To investigate the electrophysiological of characteristic in patients with sciatic nerve injury induced by intramuscular injection.Methods Needle electromyography(EMG) were performed on the illed lower limb muscles in 104 patients with sciatic nerve injury induced by intramuscular injection. Motor conduction velocity(MCV), distal motor latency(dML), and sensory conduction velocity(SCV) were tested on the common peroneal nerve, tibial nerve and posterior tibial nerve while recording distal compound muscle action potential amplitude(dCMAPA) and sensory nerve action potential amplitude(SNAPA) at the same time.H reflex of the low limb were examed in 21 cases.Results Multiple abnormalities of EMG and NCV were seen 2～7 days after intramuscular injection. The positive rate of NCV tests were higher in common peroneal nerve(68.0%) than in tibial nerve(43.5%)( P <0.05). The abnormality of common peroneal nerve SCV, SNAPA, dML and dCMAPA showed a positive correlation with desease duration prolongation( r =0.3068, P <0.005; r =0.2963, P <0.005; r =0.3376, P <0.001; r =0.2157, P <0.05). The abnormalities of common peroneal nerve SCV.SNAPA and dML tests seemed much severed 8 months after injury( P <0.05).Paired t test revealed severed abnormalities in dML and dCMAPA in motor fibers than in SCV and SNAPA of sensory fibers of same nerve( P <0.05, P <0.001). 10 cases showed H reflex absent and 1 case showed H wave latency prolongation.Conclusion Chemical medication can directly damage the transduction of myelin.The abnormalities in metor fibore of sciatic nerve may be earlier and more severe than in the sensory fibers.Assement of mortor conduction function of common peroneal nerve may benefit an early diagnosis of injured sciatic nerve.Recovery may be difficult if the injury lasts longer than 8 months.
出处
《临床神经病学杂志》
CAS
2003年第4期210-213,共4页
Journal of Clinical Neurology
