高频超声在腕管综合征中的应用价值(1)
【摘要】 目的：探究高频超声在腕管综合征(CTS)中的应用价值。方法：回顾性分析2017年11月-2019年11月于笔者所在医院收治的60例疑似CTS患者的临床资料，即研究组，以同期60例健康志愿者为对照组。两组患者均行腕部高频超声检查及肌电图，比较两组患者豌豆骨水平正中神经横截面积(CSA)。研究组患者以手术结果为诊断金标准，比较高频超声与肌电图的诊断灵敏度、特异性、诊断准确率。结果：研究组CSA、DML高于对照组，研究组SNAP低于对照组，差异均有统计学意义(P<0.05)。高频超声检查结灵敏度为94.64%，特异度为75.00%，诊断准确率为93.33%;肌电图检查灵敏度为82.14%，特异度为50.00%，诊断准确率为80.00%。高频超声与肌电图的诊断特异度比较，差异无统计学意义(P>0.05)，高频超声的灵敏度、诊断准确率均高于肌电图，差异均有统计学意义(P<0.05)。结论：高频超声在CTS的诊断中具备较高应用价值。
【关键词】 高频超声 腕管综合征 诊断 应用价值
doi：10.14033/j.cnki.cfmr.2020.19.037 文献标识码 B 文章编号 1674-6805(2020)19-00-03
The Value of High Frequency Ultrasound in Carpal Tunnel Syndrome/CHEN Dongfei. //Chinese and Foreign Medical Research， 2020， 18(19)： -94
[Abstract] Objective： To explore the application value of high frequency ultrasound in carpal tunnel syndrome (CTS). Method： The clinical data of 60 suspected CTS patients admitted to our hospital from November 2017 to November 2019 were analyzed retrospectively. As the study group， and 60 healthy volunteers as the control group. High frequency ultrasound of wrist and electromyography were performed in both groups. The cross-sectional area of median nerve (CSA) at pea bone level was compared between the two groups. In the study group， the diagnostic sensitivity， specificity and accuracy of HFUS and EMG were compared according to the operation result as the diagnostic gold standard. Result： CSA and DML in the study group were higher than those in the control group， and SNAP in the study group was lower than that in the control group， the differences were statistically significant (P<0.05). The sensitivity， specificity and accuracy of high frequency ultrasound were 94.64%， 75.00% and 93.33% respectively; the sensitivity， specificity and accuracy of electromyography were 82.14%， 50.00% and 80.00%， respectively. There was no significant difference in the diagnostic specificity between high frequency ultrasound and electromyography (P>0.05). The sensitivity and accuracy of high frequency ultrasound were higher than those of electromyography， the differences were statistically significant (P<0.05). Conclusion： High frequency ultrasound has high value in the diagnosis of CTS.
[Key words] High frequency ultrasound Carpal tunnel syndrome Diagnosis Application value
First-author’s address： Foshan Hospital of Traditional Chinese Medicine， Foshan 528000， China
腕管綜合征(CTS)属于周围神经卡压性疾病，是由各种因素引发的机体腕管内压力增高，压迫正中神经，使之缺血而诱发的手部感觉或运动功能障碍[1]。CTS临床症状主要表现为桡侧三个半手指麻木，并伴有夜间疼痛或麻醒，症状严重的部分患者可能出现腕部或手指无力、合掌困难、大鱼际肌萎缩等症状[2]。目前临床诊断CTS的方法多为电生理检查，但在临床应用中，电生理检查由于自身局限性，仅能确定正中神经损伤程度，无法检测患者腕管内具体结构。随着科技发展，超声技术逐渐被应用于临床诊断中。高频超声在患者手腕自然状态下能测量腕管神经横断面积，为CTS的临床诊断提供组织形态学依据[3]。本文旨在探究高频超声在CTS中的应用价值，现报道如下。, http://www.100md.com(陈冬菲)
【关键词】 高频超声 腕管综合征 诊断 应用价值
doi：10.14033/j.cnki.cfmr.2020.19.037 文献标识码 B 文章编号 1674-6805(2020)19-00-03
The Value of High Frequency Ultrasound in Carpal Tunnel Syndrome/CHEN Dongfei. //Chinese and Foreign Medical Research， 2020， 18(19)： -94
[Abstract] Objective： To explore the application value of high frequency ultrasound in carpal tunnel syndrome (CTS). Method： The clinical data of 60 suspected CTS patients admitted to our hospital from November 2017 to November 2019 were analyzed retrospectively. As the study group， and 60 healthy volunteers as the control group. High frequency ultrasound of wrist and electromyography were performed in both groups. The cross-sectional area of median nerve (CSA) at pea bone level was compared between the two groups. In the study group， the diagnostic sensitivity， specificity and accuracy of HFUS and EMG were compared according to the operation result as the diagnostic gold standard. Result： CSA and DML in the study group were higher than those in the control group， and SNAP in the study group was lower than that in the control group， the differences were statistically significant (P<0.05). The sensitivity， specificity and accuracy of high frequency ultrasound were 94.64%， 75.00% and 93.33% respectively; the sensitivity， specificity and accuracy of electromyography were 82.14%， 50.00% and 80.00%， respectively. There was no significant difference in the diagnostic specificity between high frequency ultrasound and electromyography (P>0.05). The sensitivity and accuracy of high frequency ultrasound were higher than those of electromyography， the differences were statistically significant (P<0.05). Conclusion： High frequency ultrasound has high value in the diagnosis of CTS.
[Key words] High frequency ultrasound Carpal tunnel syndrome Diagnosis Application value
First-author’s address： Foshan Hospital of Traditional Chinese Medicine， Foshan 528000， China
腕管綜合征(CTS)属于周围神经卡压性疾病，是由各种因素引发的机体腕管内压力增高，压迫正中神经，使之缺血而诱发的手部感觉或运动功能障碍[1]。CTS临床症状主要表现为桡侧三个半手指麻木，并伴有夜间疼痛或麻醒，症状严重的部分患者可能出现腕部或手指无力、合掌困难、大鱼际肌萎缩等症状[2]。目前临床诊断CTS的方法多为电生理检查，但在临床应用中，电生理检查由于自身局限性，仅能确定正中神经损伤程度，无法检测患者腕管内具体结构。随着科技发展，超声技术逐渐被应用于临床诊断中。高频超声在患者手腕自然状态下能测量腕管神经横断面积，为CTS的临床诊断提供组织形态学依据[3]。本文旨在探究高频超声在CTS中的应用价值，现报道如下。, http://www.100md.com(陈冬菲)