【摘要】　目的　 比較正中神經壓迫試驗對腕管綜合征（carpal tunnel syndrome，CTS）患者正中神經傳導速度的影響。　方法　 設置CTS組和對照組兩個組別，共29例受試者納入研究。CTS組為14例CTS患者，對照組為15例健康受試者。神經傳導速度測定包括正中神經和尺神經的感覺傳導末端潛伏期（distal sensory latency，DSL）、感覺神經動作電位（sensory nerve action potential， SNAP）、跨腕關節感覺傳導速度（sensory conduction velocity，SCV）、運動傳導末端潛伏期（distal motor latency，DML）及復合肌肉動作電位（compound muscle action potential，CMAP）。先測感覺傳導，再測運動傳導。正中神經壓迫試驗5 min后再次測量上述指標。　結果　 正中神經壓迫試驗前后電生理檢查考慮診斷CTS分別為22側和24側。壓迫正中神經后，CTS組正中神經DSL較壓迫前顯著延長（P lt;0.05）。CTS組尺神經和對照組正中神經及尺神經的各參數在壓迫前后均無顯著改變（P gt;0.05）。與對照組相比，在壓迫試驗前后CTS組的正中神經DSL和DML均明顯延長（P lt;0.05），尺神經DSL和DML均無顯著改變（P gt;0.05）。　結論　 正中神經壓迫試驗5 min能使CTS患者正中神經的感覺傳導末端潛伏時明顯延長，有助于提高神經傳導測定對早期CTS的診斷率。
【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 (P lt;0.05) but no significant differences were found in the median nerve DML (P gt;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 (P gt;0.05). The CTS group had longer median nerve DSL and DML than the control groups (P lt;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.

引用本文： 許驚飛,王勁松,何成奇. 正中神經壓迫試驗對腕管綜合征神經傳導速度的影響. 華西醫學, 2011, 26(12): 1839-1841. doi: 復制