摘要
目的探讨神经电生理诊断腰椎间盘突出症的临床应用价值。方法对我院48例腰椎间盘突出症患者的神经电生理检查结果进行回顾性分析。进行周围神经传导、F波及H反射的检测、常规针极检测。结果 48例中35例神经传导出现异常,异常率73%。被检测的周围神经中共检查381条神经(双下肢胫神经93、腓总神经96、腓浅神经96、腓肠神经96),异常率达21%(81/381)。肌电图检查48例中,23例出现异常,异常率为48%,共检查肌肉532块,肌肉异常91块,肌肉异常率17%,提示L_5、S1根神经源性损害7例患者占百分比15%(7/48),L_5神经根损害占23%(11/48),L_(4、5)神经根损害17%(8/48),L4、5、S_1神经根损害19%(9/48),L_(3、4、5)神经根损害6%(3/48),L_(3、4、5)、S1神经根损害6%(3/48),S1神经根损害2%(1/48)。F波潜伏期的异常率与腰椎神经根的部位密切相关,当根性损害主要累及L4、L_5神经部位时,F波传导异常率较高73%(35/48)。H反射潜伏期的异常率与骶1神经根的存在有很大关系,48例患者中,23例患者H反射未引出,异常率达48%(23/48)。结论神经电生理检查可了解腰椎间盘突出症患者的神经根定位和神经的功能状态,还可以确定损害的部位和范围,有助于鉴别诊断及判断预后,是辅助诊断腰椎间盘突出症的重要方法和判断神经损害程度的客观指标[3]。
Objective To explore value of nerve electrophysiology in clinical application of lumbar disc herniation. Methods Results of nerve electrophysiology examination of 48 patients with lumbar disc herniation in our hospital were retrospectively analyzed. They were received detections of peripheral nerve conduction, F wave and H reflex and electromyography examination. Results In 48 cases, 35 were with abnormal nerve conduction and the abnormal rate was 73%. In detection of peripheral nerves, 381 nerves were detected（93 tibial nerves in the two lower extremities, 96 common peroneal nerves, 96 superficial peroneal nerves, 96 sural nerves） and the abnormal rate was 21 %（81/381）. In 48 cases receiving electromyography examination, abnormality occurred in 23 cases and the abnormal rate was 48 %. 532 muscles were examined and 91 were with muscular abnormality. The abnormal rate was 17 %. 7 patients were with L_5, S1 neurogenic injuries accounting for 15%（7/48）. L_5 nerve root lesions accounted for 23%（11/48）. L_4 and L_5 nerve root lesions accounted for 17%（8/48）. L_4, L_5 and S_1 nerve root lesions accounted for 19%（9/48）. L3, L_4, L_5 nerve root lesions accounted for 6%（3/48）. L3, L_4, L_5, S1 nerve root lesions accounted for 2%（1/48）. Abnormal rate during latent period of F wave was closely related to location of lumbar nerve root. When root lesions were involved in L_4 and L_5 nerves, abnormal rate of F wave conduction was 73 %（35/48） which was a little bit higher. Abnormal rate during latent period of H reflex was closely related to sacral nerve root. In 48 patients, H reflex of 23 patients was not induced. The abnormal rate reached 48%（23/48）. Conclusion Nerve electrophysiology can not only determine locations of nerve roots and nerve functions but also identity location and ranges of lesions, which is helpful for differential diagnosis and prognosis judging. Thus, it is an important method for aided diagnosis of lumbar disc herniation and a subjective index for judging degrees
出处
《中国医药科学》
2016年第3期21-24,32,共5页
China Medicine And Pharmacy
关键词
肌电图
神经电生理
腰椎间盘突出症
腰骶神经根病
Electromyography
Nerve electrophysiology
Lumbar disc herniation
Lumbosacral radiculopathy
