EMG诊断臂丛神经损伤的临床特征观察.docVIP

EMG诊断臂丛神经损伤的临床特征观察 　　[摘要] 目的 观察分析肌电图（EMG）诊断臂丛神经节前损伤的临床特征。 方法 检测48例患者的三角肌、肱二头肌、伸指总肌、小指展肌、拇短展肌及腋神经、肌皮神经、桡神经、正中神经、尺神经，应用EMG仪测定支配肌肉的EMG及运动神经传导速度、感觉神经传导速度，对运动单位电位进行研究，并观察肌肉的自发电活动，同时测定神经的复合肌肉动作电位，计算出神经传导速度和潜伏期。 结果 48例患者中，不完全损伤30例，完全损伤18例；根以下受损33例，根性受损15例。 结论 EMG诊断对臂丛神经损伤的诊断、定位、定性分类都具有重要意义。 　　[关键词] 临床特征；肌电图；臂丛神经损伤 　　[中图分类号] R338 [文献标识码] A [文章编号] 1674-4721（2013）11（b）-0014-02 　　Clinical features of observation on EMG in diagnosing brachial plexus injury 　　LI Bin1 XIA Wen-jiao2 　　1.The First Hospital Affiliated China Medical University，Shenyang 110001，China；2.China Medical University，Shenyang 110001，China 　　[Abstract] Objective To observe and analyze the clinical features of EMG in diagnosing brachial plexus injury. Methods The deltoid，biceps，extensor digitorum muscle abductor muscle abductor pollicis brevis and axillary nerve，musculocutaneous nerve，radial nerve，median nerve，ulnar nerve of 48 cases were detected.The dominate muscle electromyography and motor nerve conduction velocity，sensory nerve conduction velocity was detected by EMG instrument.The motor unit potential was studied，and observed the spontaneous electrical activity of the muscles，the nerve compound muscle action potential was deterred at the same time，calculateed the nerve conduction velocity and the incubation period. Results In 48 patients，30 cases were incomplete injury patients，18 cases were completely injury patients；33 cases were below the root damage，15 cases were the root damage. Conclusion EMG diagnosis has important significance in the diagnosis of brachial plexus injury，positioning，qualitative classification. 　　[Key words] Clinical characteristics；EMG；Brachial plexus injury 　　臂丛神经损伤是周围神经损伤中较为常见的一种类型，其多因外伤所致，且损伤类型较为复杂。按照臂丛神经损伤的病因可分为外伤性臂丛神经损伤和非外伤性臂丛神经损伤。外伤性臂丛神经损伤主要由交通意外伤、颈肩部外伤、枪弹伤、刀割伤等引起；非外伤性臂丛神经损伤由痛性肌萎缩、麻醉药物的注射、牵拉、某一位置将肢体长时间固定等引起[1]。在诊断臂丛神经损伤的过程中，肌电图（EMG）检测不但能够观察神经肌肉功能、确定损伤部位，还可以确定损伤的严重程度及损伤类型，估计预后及是否需要手术和指导康复治疗。本研究对2012年5月～2013年5月本院门诊及病房收治的48例臂丛神经损伤患者行常规EMG检测，现报道如下。 　　1 资料与方法 　　1.1 一