Abstract:

Objective　To analyze the application value of different electrophysiological methods in the diagnosis of cubital tunnel syndrome (CuTS). Methods　A total of 45 patients (90 upper limbs) clinically diagnosed with CuTS in Nanjing University of Chinese Medicine Affiliated Lianyungang Hospital from October 2019 to October 2022 were collected as the observation group, including 31 males and 14 females, aged 26 to 81 (51.3±13.1) years. The 90 upper limbs were divided into a symptomatic limb group (50 limbs) and an asymptomatic limb group (40 limbs) according to whether there were the clinical symptoms of CuTS or not. In addition, 30 healthy volunteers (60 upper limbs) were selected as the control group, including 20 males and 10 females, aged 28 to 79 (50.3±11.6) years. Nerve conduction velocity (NCV), needle electromyography (EMG) and short-segment micro-shift conduction time (SSCT) were measured, and the relevant parameters were compared between the two groups. Independent sample t test and χ² test were used. Results　Compared with those in the control group, the motor nerve conduction velocity (MNCV) of the ulnar nerve in the observation group decreased in the wrist-lower elbow segment [(50.79±5.98) m/s vs. (59.15±5.15) m/s] and the lower-upper elbow segment [(48.07±7.14) m/s vs. (55.77±5.35) m/s], and the complex muscle action potential (CMAP) amplitude decreased in the wrist segment [(9.16±4.18) mV vs. (13.91±4.25) mV], 5 cm of lower elbow segment [(7.63±3.59) mV vs. (13.46±3.92) mV], and 5 cm of upper elbow segment [(8.27±3.73) mV vs. (13.02±3.70) mV], with statistically significant differences (all P<0.05). In the asymptomatic limb group, the abnormal rate of NCV was 12.5% (5/40), there was a statistically significant difference compared with that of SSCT detection [45.0% (18/40)] (χ²=10.313, P=0.001). Most of the compression areas detected by SSCT were located from 3 cm above the elbow to 2 cm below the elbow (total 5 cm), accounting for 96.9% of the marked areas. The compression rate of 1 cm above the elbow was the highest. Conclusions　Different electrophysiological detection methods play an important role in early diagnosis, qualitative diagnosis, and treatment. SSCT is an important detection method for early diagnosis of CuTS and identification of compression sites.

Key words:

Cubital tunnel syndrome, Short-segment micro-shift conduction time, Localization diagnosis, Electrophysiology

摘要：

目的　分析不同电生理检测方法在诊断肘管综合征（CuTS）中的应用价值。方法　搜集2019年10月至2022年10月期间于南京中医药大学连云港附属医院临床诊断为CuTS的患者共45例（90个上肢）作为观察组，男31例，女14例，年龄26～81（51.3±13.1）岁；90个上肢根据有无CuTS临床症状分为有症状肢体组（50肢）和无症状肢体组（40肢）。并纳入同期健康志愿者30例（60个上肢）作为对照组，男20例，女10例，年龄28～79（50.3±11.6）岁。进行神经传导速度（NCV）、针极肌电图（EMG）、短段微移传导时间（SSCT）测定，比较两组相关参数差异。采用独立样本t检验和χ²检验。结果　与对照组比较，观察组尺神经运动神经传导速度（MNCV）在腕段-肘下段［（50.79±5.98）m/s比（59.15±5.15）m/s］、肘下段-肘上段［（48.07±7.14）m/s比（55.77±5.35）m/s］减慢，复合肌肉动作电位（CMAP）波幅在腕段［（9.16±4.18）mV比（13.91±4.25）mV］、肘下段5 cm［（7.63±3.59）mV比（13.46±3.92）mV］、肘上段5 cm［（8.27±3.73）mV比（13.02±3.70）mV］降低，差异均有统计学意义（均P<0.05）。无症状肢体组中NCV异常率为12.5%（5/40），与SSCT检测异常率［45.0%（18/40）］比较，差异有统计学意义（χ²=10.313，P=0.001）。应用SSCT检测法卡压区域大多分布于肘上3 cm至肘下2 cm（共5 cm）的位置，占明确标记的96.9%，其中肘上1 cm卡压率最高。结论　不同电生理检测方式对临床早期定位、定性诊断及治疗有重要的指导价值，其中SSCT是早期诊断CuTS、明确卡压位点的重要检测方式。

关键词:

肘管综合征, 短段微移传导时间, 定位诊断, 电生理