摘要
目的 探讨肘管综合征的发病原因 ,评价尺神经传导速度 (NCV)检查在术前诊断肘管综合征的临床价值。方法 对临床上伴有尺神经分布区受损症状及体征的患者 ,进行尺神经感觉神经传导速度 (SCV)及运动神经传导速度 (MCV)分段测定 ,并对这些患者进行尺神经前移术治疗。结果 共有 2 1例 (2 2肢 )行尺神经传导速度分段测定并手术治疗。尺神经SCV测定 ,1 4例 (1 4肢 )异常 ,其中 1 2例未引出电位 ;MCV肘上至肘下段测定 ,2 0例 (2 1肢 )减慢。手术证实尺神经受压原因为 :韧带、肌腱及骨质增生压迫尺神经 1 5肢 ,粘连 2肢 ,扩张静脉及静脉丛压迫 3肢 ,囊性肿物压迫2肢。结论 本组肘管综合征发病原因 ,除文献报道的常见病因外 ,还有其他少见原因 ,包括充盈的静脉丛 ,粗大静脉 ,囊肿压迫尺神经等。尺神经肘段运动神经传导速度减慢对肘管综合征有一定诊断价值。
Objectives To determine the causes of cubital tunnel syndrome by performing operation,and to assess the clinical value of neurophysiologic diagnosis in cubital tunnel syndrome Methods Twenty one patients (22 limbs from 16 men and 5 women, aged from 22 to 63 years, with mean age of 49 years)suspected of ulnar nerve involved in clinical symptoms and the signs of ulnar distribution were recorded with motor conduction velocity at different sites along with the ulnar nerve and sensory conduction velocity in the hand,and underwent anterior transposition of the ulnar nerve Results Electromyographic abnormality was seen in 21/22 (range MCV 15.9～47.5 m/s,mean 32.7 m/s) of patients with motor conduction velocity in across elbow segment of the ulnar nerve. And slowing was seen in 13/22 (MCV 15.7～59.6 m/s, mean 40.4 m/s )patients with MCV in the forearms. The absent or abnormal evoked sensory nerve action potential was seen in 14/22 patients in the little finger. The factors of ulnar compressed in this study by operation were:15 ulnar nerves compressed by arcuate ligaments, or muscle tendons, or bone hyperplasia; two were involved in fibrous by adhesion;three compressed by venous plexus or concurrent thick vein;two compressed by cysts Conclusions The factors of cubital tunnel syndrome include either the common factors reported or the rare factors, such as the venous plexus, thick vein and cysts. The tests of motor conduction velocity at different sites along the ulnar nerve should be helpful in diagnosis of cubital tunnel syndrome, especially the slowing velocity of MCV across the elbow segment.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2003年第2期110-112,共3页
Chinese Journal of Neurology
