【摘要】 目的 比较正中神经压迫试验对腕管综合征（carpal tunnel syndrome，CTS）患者正中神经传导速度的影响。 方法 设置CTS组和对照组两个组别，共29例受试者纳入研究。CTS组为14例CTS患者，对照组为15例健康受试者。神经传导速度测定包括正中神经和尺神经的感觉传导末端潜伏期（distal sensory latency，DSL）、感觉神经动作电位（sensory nerve action potential， SNAP）、跨腕关节感觉传导速度（sensory conduction velocity，SCV）、运动传导末端潜伏期（distal motor latency，DML）及复合肌肉动作电位（compound muscle action potential，CMAP）。先测感觉传导，再测运动传导。正中神经压迫试验5 min后再次测量上述指标。 结果 正中神经压迫试验前后电生理检查考虑诊断CTS分别为22侧和24侧。压迫正中神经后，CTS组正中神经DSL较压迫前显著延长（Plt;0.05）。CTS组尺神经和对照组正中神经及尺神经的各参数在压迫前后均无显著改变（Pgt;0.05）。与对照组相比，在压迫试验前后CTS组的正中神经DSL和DML均明显延长（Plt;0.05），尺神经DSL和DML均无显著改变（Pgt;0.05）。 结论 正中神经压迫试验5 min能使CTS患者正中神经的感觉传导末端潜伏时明显延长，有助于提高神经传导测定对早期CTS的诊断率。【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 (Plt;0.05) but no significant differences were found in the median nerve DML (Pgt;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 (Pgt;0.05). The CTS group had longer median nerve DSL and DML than the control groups (Plt;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.
OBJECTIVE: To study the changes of neural electrophysiology properties of cauda equina under double level compression and dynamic burdens, and to clarify the mechanisms of intermittent neurogenic claudication. METHODS: Thirty SD rats were divided into 5 groups (6 in each group). The laminectomy of L5 was performed in control group. In the experimental groups, the silicon sheets were inserted into the spinal canal of L4 and L6 to cause double level compression of cauda equina by 30%. Two hours after onset of compression, no dynamic burden was introduced in experimental group 1. Only high frequency stimulation(HFS) was introduced for 6 minutes in experimental group 2. Both HFS and additional increased compression were introduced for 6 minutes in experimental group 3. While only additional increased compression was introduced for 6 minutes in experimental group 4. After 6 minutes of dynamic burdens, all were returned to the status of static compression for another 30 minutes and then electrical examination was made. RESULTS: After 2 hours of compression, motor and sensory nerve conduction velocity (NCV) of all the four experimental groups decreased significantly (P lt; 0.05), but there was no significant difference between them. There was no significant change in the control group. There was no significant change of NCV in experimental group 1 during the last 30 minutes of experiment. NCV in the other three experimental groups decreased after introduction of dynamic burdens, especially in the experimental group 3. CONCLUSION: The above results showed that NCV of cauda equina decreased significantly under dynamic burdens during static compression. Two kinds of dynamic burdens introduced at the same time can cause more profound change than a single one.
The changes of nerve function were observed from the study of electrophysiology and histomorphology in 15 rabbits undergoing gradual lengthening of the legs from different rates and magnitudes. The results showed that if the leg was increased at a rate of 1 mm per day would not result in any changes of nerve morphology or functional damage. The conduction rate of the motor nerve and the potential of the muscular action were all normal; if at a rate of 2mm per day, the leg length was increased within 40％, it was still quite safe. It was believed that the peripheral nerve markedly tolerable to gradual lengthening from traction.
ObjectiveTo study the effect of combined treatment using pancreatic kinionogenase enteric-coated tab and mecobalamin injection on diabetic peripheral neuropathy (DPN) patients. MethodsWe collected 84 subjects with DPN who received treatment from January 2012 to December 2012 in our hospital, and we randomly divided them into treatment group (42 subjects, using pancreatic kinionogenase enteric-coated tab and methylcobalamin injection) and control group (42 subjects, using mecobalamine only). Subjects in the treatment group were given oral pancreatic kininogenase at 120 unit/times and 3 times/day, and methylcobalamin intravenous injection at 1 mg/day for 14 days. Subjects in the control group were only given methylcobalamin intravenous injection at 1 mg/day for 14 days. ResultsIn the treatment group, 22 subjects showed excellent, 19 subjects effective and 1 subject ineffective outcome. In the control group, 8 subjects showed excellent, 22 effective and 12 ineffective outcome. The difference between the two groups is statistically significant (P<0.01). Compared with no treatment, the nerve conduction velocity in both the two groups has been improved. The improvement in the treatment group is significantly better than that of the control group (P<0.01), and all of them had no obvious adverse reaction during the treatment. ConclusionThe combined treatment using pancreatic kinionogenase enteric-coated tab and methylcobalamin injection on DPN is better than using methylcobalamin only.