腕管综合征40例临床和神经电生理研究.docVIP

腕管综合征40例临床和神经电生理研究 　　doi：10.3969/j.issn.1007-614x.2014.4.68 摘 要 目的：分析腕管综合征（CTS）患者的临床及神经电生理特征，提高全科医师临床诊断及时性、准确性。方法：56例手麻患者测双侧正中神经、尺神经的运动传导速度（MCV）和感觉传导速度（SCV），其中40例行微移法检查腕部正中神经。结果：56例手麻患者中40例为CTS，24例正中神经末端运动潜伏期（DML）延长（≥4.5ms）；40例均SCV减慢（≤46m/秒）；40例均有腕部正中神经传导阻滞（≥0.5ms/cm）。微移法为3项检查中最为敏感的指标，SCV异常早于DML异常。结论：患者症状及体征非特异性时，排除主要内科疾病后，神经电生理检查早期是诊断CTS最有效的方法之一，全科医师需积极依托三级医院，及时转诊。 关键词 腕管综合征 临床 神经电生理 Clinical and electrophysiological study of 40 cases of carpal tunnel syndrome Yang Qiaofeng Two Shimen Road Street Community Health Service Center of Jingan District，Shanghai City，200000 Abstract Objective：To analyze the Clinical and electrophysiological features of carpal tunnel syndrome patients and to improve the timeliness and accuracy of clinical diagnosis.Methods：The motor conduction velocity and sensory nerve conduction velocity of bilateral median nerve and ulnar nerve of 56 cases with numbness in the hand were measured.In the 56 cases，40 cases were measured in wrist median nerve with inching technique.Results：In the 56 cases with numbness in the hand，40 cases was CTS and the distal motor latency of he median nerve of 24 cases was prolonged（≥4.5ms）.40 cases of SCV were slow（≤46m/s）；40 cases of wrist median nerve were conduction block（≥0.5ms/cm）.Inching technique was the most sensitive index in the 3 examinations.The abnormality of SCV was earlier than DML.Conclusion：When the symptoms and signs of patients are nonspecific，exclusion of the main diseases in Department of internal medicine，neural electrophysiological examination is one of the most effective methods for early diagnosis of CTS.General practitioners should be based on the three level of hospital，and timely transfer the patients. Key words Carpal tunnel syndrome；Clinical；Electrophysiological 手指或四肢发麻是社区中老年人常见主诉之一，其原因有很多，常见疾病如糖尿病、甲状腺疾病、颈椎病等均可导致。2013年4-12月在上海市静安区石门二路社区卫生服务中心就诊，已排除内分泌疾病、脑血管疾病及颈椎病，临床仍未明确诊断的56例上肢麻木病例，经瑞金医院神经电生理检测，40例明确诊断为腕管综合征（CTS）。 资料与方法 2013年4-12月上海市静安区石门二路社区卫生服务中心诊治门诊患者56例，因肢