摘要
目的 采用电生理检测手段 ,研究先天性马蹄内翻足患儿下肢神经和肌肉功能的变化 ,为有关该病病因学研究及其治疗方案的设计和疗效评价提供客观依据。方法 采用电生理检测手段 ,用丹麦产维迪KEYPOINT 4C诱发电位仪 ,对 42例临床确定为先天性马蹄内翻足的患儿进行了电生理检查。其中男 2 9例 ,女 1 3例 ,年龄 0 .5～ 1 2岁 ,平均 (2 6 .48± 36 .43)个月 ,身高 60～ 1 50cm ,平均 (80 .57± 2 2 .1 9)cm。其中双侧马蹄内翻足患儿 1 8例 ,单侧 2 4例。临床检查显示 ,足踝部呈马蹄内翻畸形 ,轻度 1 2例 1 4足 ,中度 1 7例 2 5足 ,重度 1 3例 2 1足。分别在窝、踝部阈值刺激腓总神经和胫神经 ,刺激频率 2Hz ,波宽 0 .2ms,分析时间 40ms,刺激强度 41～ 99mA ,平均 (85 .34± 2 1 .34)mA。在踝部伸趾短肌和展肌处记录肌肉的动作电位 ,并测量潜伏期和波幅 ,计算运动神经传导速度和潜伏速率。结果 42例患儿 60侧患肢电生理检查发现 ,有 37例 53侧 (88.1 % )均有异常改变。其中有 8例 1 2侧 (1 9.1 % )患肢最大刺激下均未引出肌肉动作电位 ;8例 1 2侧 (1 9.1 % )患肢肢体腓总神经或胫神经运动神经传导速度、潜伏速率减慢 ;2 1例 2 9侧 (50 .0 % )患肢仅表现动作电位波幅下降。只有 5例 7侧 (1 1 .9% )
Objective To examine the functional alt er ations in nerves and muscles of the lower extremities, provide scientific ground s on the etiology and assess the outcome of treatment by electrophysiological studies in congenital clubfoot. Methods Fourty-two patients (60 foot) of clubfoot agi ng from 6 months to 12years (mean 26.48 ± 36.43 months) were examined. O f them, electrophysiologically with particular reference to the latency, conduct ion velocity, amplitude of muscle action potential were measured using an evoked potential apparatus Keypoint 4C (Denmark). Stimulating pulses of 2 Hz with 0. 2 ms duration were used. Results Of the 60 limbs in 42 patients, 53 limbs ( 88.1 %) in 37 patients had abnormal findings and only 7 limbs ( 11.9 %) in 5 pati ents were found to be no significant abnormality during the electrophysiologica l examination. Conclusion The current study is supportive of the neuromu scular etiology theory of congenital clubfoot, thus providing valuable objective parameters that would be conductive to correct diagnosis and valid assessment measures of the results following surgical treatment.
出处
《中华小儿外科杂志》
CSCD
北大核心
2003年第4期351-352,共2页
Chinese Journal of Pediatric Surgery
