标题：正中神经节段检查法诊断早期腕管综合征的临床价值

      作者：党丽丽，李建军，高弘，刘会芳，马海燕    (榆林市星元医院神经内科，陕西 榆林 719000)

      卷次： 2017年28卷8期

      【摘要】 目的 观察神经节段检查法(Inching)诊断早期腕管综合征(CTS)的临床价值。方法 对我院2015年6月至2016年6月33例早期CTS患者行正中神经、尺神经常规神经传导检测后，再行Inching检测，同时选择健康体检者30例分别行神经传导检测和 Inching检测，比较两组受检者的 Inching检测结果。结果 CTS组患者和对照组的S-Inching检测LD横纹-腕下1 cm [(0.22±0.02) vs (0.17±0.03) ms/cm]、腕下2~3 cm [(0.71±0.14) vs (0.23±0.04) ms/cm]、3~4 cm [(0.74±0.21) vs (0.24±0.05) ms/cm]、4~5 cm [(0.32±0.10) vs (0.21±0.04) ms/cm]值比较，CTS组患者均明显高于对照组，差异均有统计学意义(P<0.05)；CTS组患者和对照组的M-Inching检测LD腕下 1~2 cm [(0.62±0.11) vs(0.37±0.08）ms/cm]、腕下2~3 cm [(1.32±0.20) vs (0.56±0.10) ms/cm]值比较，CTS组患者均明显高于对照组，差异均有统计学意义(P<0.05)；CTS组患者经神经传导检测正中神经感觉传导和正中神经运动传导异常率分别为66.67%(22/33)和60.61% (20/33)，敏感性为66.67%；S-Inching和M-Inching检测异常率分别为93.94% (31/33)和87.88% (29/33)，敏感性为93.94%，Inching检测法敏感性明显高于神经传导检测，差异有统计学意义(P<0.05)。结论 Inching检测法对早期腕管综合征诊断的敏感度高，且方便、经济、无痛，具有较高的临床应用价值。
      【关键词】 神经节段；腕管综合征；早期；诊断价值
      【中图分类号】 R745 【文献标识码】 A 【文章编号】 1003—6350（2017）08—1336—03

Clinical value of median nerve segments for diagnosing early carpal tunnel syndrome.
DANG Li-li, LI Jian-jun,GAO Hong, LIU Hui-fang, MA Hai-yan. Department of Internal Medicine-Neurology, the Xingyuan Hospital of Yulin, Yulin719000, Shaanxi, CHINA
【Abstract】 Objective To observe the clinical value of median nerve segments test (Inching test) in the diagno-sis of early carpal tunnel syndrome (CTS). Methods In our hospital from June 2015 to June 2016, 33 patients withearly CTS (CTS group) and 30 healthy controls (control group) underwent nerve conduction tests of median nerve, ul-nar nerve, followed by Inching test. The Inching test results were compared between the two groups. Results The LDvalues of S-Inching test under the horizontal stripes-wrist 1 cm, wrist 2-3 cm, wrist 3-4 cm, wrist 4-5 cm were signifi-cantly higher than those in the control group, (0.22±0.02) ms/cm vs (0.17±0.03) ms/cm, (0.71±0.14) ms/cm vs (0.23±0.04) ms/cm, (0.74±0.21) ms/cm vs (0.24±0.05) ms/cm, (0.32±0.10) ms/cm vs (0.21±0.04) ms/cm, all with P<0.05. TheLD values of M-Inching test under wrist 1-2 cm, wrist 2-3 cm were significantly higher than those in the control group,(0.62±0.11) ms/cm vs (0.37±0.08) ms/cm, (1.32±0.20) ms/cm vs (0.56±0.10) ms/cm, all with P<0.05. The abnormalityrate of median nerve sensory conduction and the median nerve motor conduction in nerve conduction test was 66.67%(22/33) and 60.61% (20/33) in CTS group, and the sensitivity was 66.67%. The abnormal rate by S-Inching and M-Inch-ing were 93.94% (31/33) and 87.88% (29/33) respectively, and the sensitivity was 93.94%, which was significantly high-er than 66.67% for nerve conduction test (P<0.05). Conclusion Inching test has high sensitivity in the diagnosis of ear-ly CTS, which is convenient, economic, painless, and has high clinical value.
      【Key words】 Nerve segments; Carpal tunnel syndrome; Early; Diagnostic value·临床经验·doi:10.3969/j.issn.1003-6350.2017.08.047