超声与神经电生理检查在肘管综合征诊断中的对比研究

摘要

Objective To compare the application value of high frequency ultrasound and neural electrophysiological examination in diagnosis of cubital tunnel syndrome(CTS). Methods High frequency ultrasound and neural electrophysiological examination were performed in 100 patients with unilateral cubital tunnel syndrome (the affected side limb as the CTS group,the contralateral side limb as the control group). The cross-sectional area (CSA) of the elbow ulnar nerve was measured in the two groups by high frequency ultrasound. The motor nerve conduction velocity (MNCV) was measured by neural electrophysiological examination. And pearson correlation between the largest CSA and MNCV was analyzed in CTS group. By taking the surgical results as the gold standard,the accuracy rate in diagnosis of CTS was compared between the two methods. Results The elbow ulnar nerve largest CSA[(0.14±0.05) cm2] in CTS group was higher than that in control group[(0.06±0.01)cm2],there was significant difference(P<0.01).The elbow ulnar nerve MNCV[(28.53±9.52) m/s] in CTS group was lower than that in control group[(56.17±3.18)m/s],there was significant difference(P<0.01). The elbow ulnar nerve largest CSA was negatively correlated with the MNCV (r=-0.80,P<0.01)in CTS group. The accuracy rate of high frequency ultrasound and neural electrophysiological examination in the diagnosis of CTS was 92% and 90%, respectively. Conclusion High frequency ultrasound and neural electrophysiological examination has important value in diagnosis of CTS. Combination of the two methods could provide more reliable evidence for diagnosis and treatment of CTS.%目的：比较高频超声与神经电生理检查在肘管综合征诊断中的应用价值。方法对100例经临床诊断为单侧肘管综合征的患者（患侧肢体为患侧组，健侧肢体为健侧组）行高频超声及神经电生理检查，高频超声测量两组肘部尺神经的最大横截面积（CSA），神经电生理检查测量肘上-肘下段运动传导速度（MNCV），并对患侧组肘部尺神经的最大CSA与MNCV行Pearson相关性分析。以手术结果为金标准，比较两种方法诊断肘管综合征的准确率。结果患侧组肘部尺神经最大CSA为（0.14±0.05）cm2，大于健侧组（0.06±0.01）cm2，差异有统计学意义（P＜0.01）；患侧组肘上-肘下段MNCV为（28.53±9.52）m/s，低于健侧组（56.17±3.18）m/s，差异有统计学意义（P＜0.01）。患侧组肘部尺神经最大CSA与MNCV呈负相关（r=-0.80，P＜0.01）。高频超声诊断肘管综合征的准确率为92%，神经电生理检查准确率为90%。结论高频超声与神经电生理检查对肘管综合征的诊断均有重要价值，两者联合应用将为肘管综合征的诊治提供更可靠的依据。