肌电图检查评估腕管综合征手术效果的临床分析

目的:探讨采用肌电图检查评估腕管综合征的手术治疗效果。方法:选取35例(患侧手共39侧)临床确诊为腕管综合征并接受腕管切开减压术治疗的患者,于手术前后分别行肌电图检查,应用正中神经传导检查和拇短展肌针极肌电图检查,分析患者手术前和手术后腕部正中神经功能的变化情况。结果:手术后,患者正中神经感觉传导潜伏期异常率(33%)、正中神经运动传导潜伏期异常率(36%)较手术前(72%、74%)明显下降(P0.05),正中神经感觉传导波幅(7.40±5.05)较手术前(4.86±3.60)显著降低(P0.001),拇短展肌静息状态下失神经电位的异常率(69%)、重收缩时募集电位异常率(13%)均较手术前(85%、26%)明显下降(P0.05)。患者手术前后正中神经感觉传导速度和运动传导速度对比差异无统计学意义(P0.05)。结论:腕管切开减压术可解除正中神经卡压状态,明显恢复正中神经功能,增强拇短展肌肌力,临床治疗效果好。肌电图检查可为腕管综合征患者手术治疗效果的评估提供客观的依据。

Clinical Analysis of Electromyography in Evaluating the Surgical Effect of Carpal Tunnel Syndrome

ABSTRACT Objective: To evaluate the surgical treatment effect of carpal tunnel syndrome by electromyography. Methods: A total of 35 patients (39 sides of the affected hand) who were clinically diagnosed with carpal tunnel syndrome and underwent open carpal tunnel release surgery were selected. Electromyography was performed before and after operation. The median nerve conduction test and the needle electromyography of abductor pollicis brevis muscle were used to analyze the changes of median nerve function in the wrist before and after surgery. Results: After surgery, the abnormal rate of median nerve sensory conduction latency (33 %) and median nerve motor conduction latency (36 %) was significantly lower than that before surgery (72 %, 74 %) (P<0.05). Median nerve sensory conduction amplitude (7.40±5.05) was significantly lower than that before surgery (4.86±3.60) (P<0.001). The abnormal rate of denervation potential (69 %) in the resting state of abductor pollicis brevis muscle and the abnormal rate of heavy contractive recruitment potential (13 %) were significantly lower than those before surgery (85 %, 26 %) (P<0.05). There was no statistically significant differences in median nerve sensory conduction velocity and motor conduction velocity between patients before and after surgery (P>0.05). Conclusion: Open carpal tunnel release surgery can relieve the entrapment state of median nerve, obviously restore the function of median nerve, and enhance the muscle strength of the abductor pollicis brevis muscle. The electromyography examination can provide an objective basis for the evaluation of surgical treatment effect in patients with carpal tunnel syndrome.