【摘要】　目的　 比較正中神經(jīng)壓迫試驗(yàn)對(duì)腕管綜合征（carpal tunnel syndrome，CTS）患者正中神經(jīng)傳導(dǎo)速度的影響。　方法　 設(shè)置CTS組和對(duì)照組兩個(gè)組別，共29例受試者納入研究。CTS組為14例CTS患者，對(duì)照組為15例健康受試者。神經(jīng)傳導(dǎo)速度測(cè)定包括正中神經(jīng)和尺神經(jīng)的感覺傳導(dǎo)末端潛伏期（distal sensory latency，DSL）、感覺神經(jīng)動(dòng)作電位（sensory nerve action potential， SNAP）、跨腕關(guān)節(jié)感覺傳導(dǎo)速度（sensory conduction velocity，SCV）、運(yùn)動(dòng)傳導(dǎo)末端潛伏期（distal motor latency，DML）及復(fù)合肌肉動(dòng)作電位（compound muscle action potential，CMAP）。先測(cè)感覺傳導(dǎo)，再測(cè)運(yùn)動(dòng)傳導(dǎo)。正中神經(jīng)壓迫試驗(yàn)5 min后再次測(cè)量上述指標(biāo)。　結(jié)果　 正中神經(jīng)壓迫試驗(yàn)前后電生理檢查考慮診斷CTS分別為22側(cè)和24側(cè)。壓迫正中神經(jīng)后，CTS組正中神經(jīng)DSL較壓迫前顯著延長(zhǎng)（P lt;0.05）。CTS組尺神經(jīng)和對(duì)照組正中神經(jīng)及尺神經(jīng)的各參數(shù)在壓迫前后均無(wú)顯著改變（P gt;0.05）。與對(duì)照組相比，在壓迫試驗(yàn)前后CTS組的正中神經(jīng)DSL和DML均明顯延長(zhǎng)（P lt;0.05），尺神經(jīng)DSL和DML均無(wú)顯著改變（P gt;0.05）。　結(jié)論　 正中神經(jīng)壓迫試驗(yàn)5 min能使CTS患者正中神經(jīng)的感覺傳導(dǎo)末端潛伏時(shí)明顯延長(zhǎng)，有助于提高神經(jīng)傳導(dǎo)測(cè)定對(duì)早期CTS的診斷率。
【Abstract】　Objective　 To determine the effect of median nerve compression on median nerve conduction speed in patients with carpal tunnel syndrome (CTS).　Methods　 In this case-control study, 29 subjects were enrolled. CTS group included 14 patients (22 hands) with CTS confirmed by electrodiagnostic studies, while the control group included 15 healthy subjects (30 hands). The across wrist nerve conduction of median and ulnar nerve was measured when the wrist was in neutral position. Measured parameters included distal sensory latency (DSL), sensory nerve action potential (SNAP), sensory conduction velocity (SCV), distal motor latency (DML) and compound muscle action potential (CMAP). Sensory nerve conductions were tested first, and then the motor nerve conduction. The patients were asked to perform the median nerve compression test by flexing elbows, pronating forearm and pushing the dorsal surfaces of both hands together into maximum wrist flexion for 5 minutes. Then the above parameters were measured again.　Results　 By electrodiagnostic studies, 22 hands and 24 bands were diagnosed with CTS before and after the median nerve compression test, respectively. After the compression test, the median nerve DSL were significantly prolonged in CTS group (P lt;0.05) but no significant differences were found in the median nerve DML (P gt;0.05). The parameters of ulnar nerve in group CTS and median nerve and ulnar nerve in control group failed to show any significant change (P gt;0.05). The CTS group had longer median nerve DSL and DML than the control groups (P lt;0.05), but the differences in ulnar nerve DSL and DML were not significantly between the two groups.　Conclusion　 A 5-minute median nerve compression test may make the median nerve DSL prolonged and may be a helpful diagnosis of early CTS.

引用本文： 許驚飛,王勁松,何成奇. 正中神經(jīng)壓迫試驗(yàn)對(duì)腕管綜合征神經(jīng)傳導(dǎo)速度的影響. 華西醫(yī)學(xué), 2011, 26(12): 1839-1841. doi: 復(fù)制

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