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臂丛根性损伤两种神经电图-肌电图检测方法的诊断符合率 被引量:17

Combined application of multiple electrophysiological examinations for diagnosis of root injuries of the brachial plexus
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摘要 目的比较两种神经电图-肌电图检测方法对臂丛根性损伤的诊断符合率。方法1997年前,对82例臂丛根性损伤用上肢五大神经代表肌肉及肩胛带肌群肌电图(EMG)、复合肌肉动作电位(CMAP)、运动神经传导速度(MNCV)、感觉神经诱发电位和传导速度(SNAP、SNCV)及体感诱发电位(SEP)进行分析诊断。1997年起,对118例臂丛根性损伤加测颈椎旁肌EMG、双侧膈肌的CMAP和斜方肌的EMG、CMAP进行诊断。结果1997年至今,臂丛根性损伤神经电图-肌电图的诊断和术中发现相比,诊断完全符合率为80%,完全及基本符合率为95.4%,比1997年前分别提高14.1%和10.3%。结论臂丛神经根性损伤加测椎旁肌EMG、膈神经、副神经肌电可提高臂丛根性损伤尤其是C5节后损伤的肌电诊断正确率。 Objective To investigate the value of combined use of multiple electrophysiological examinations in the diagnosis of brachial plexus root injuries. Methods 200 cases of brachial plexus root injuries were reviewed about the preoperative electrophysiologic diagnosis and the surgical findings. 82 cases were treated before 1997. Preoperative examinations included electromyogram(EMG), compound muscle action potential(CMAP) of the muscles of shoulder girdle and the representing muscles of the five major nerves in the upper extremity, motor nerve conducting velocity(MNCV), sensory nerve action potential(SNAP), sensory nerve conducting velocity(SNCV), and somatosensory evoked potential(SEP). EMG of cervical paraspinal muscles, CMAP of bilateral diaphragms, and EMG and CMAP of trapezius muscle were also tested in addition to the above mentioned examinations for the 118 cases treated since 1997. Results According to intraoperative exploration, the completely correct diagnostic rate of electrophysiologic examination was 80Electrophysiologic examination of cervical paraspinal muscles and the functional assessment of phrenic nerve and accessory nerve could raise the diagnostic rate of brachial plexus root injuries, in particular postganglionic lesion of C 5 nerve root.
出处 《中华手外科杂志》 CSCD 1998年第4期215-217,共3页 Chinese Journal of Hand Surgery
基金 美国中华医学基金 上海市医学领先学科基金 国家自然科学基金 卫生部重点学科基金
关键词 肌电描记术 臂丛神经损伤 脊神经根 电诊断 损伤 Electromyography Brachial plexus Spinal nerve roots Electrodiagnosis Wounds and injuries
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