| 术中电生理监测在儿童肘部骨折合并尺神经损伤中的应用 |
| 投稿时间：2017-09-10 修订日期：2017-10-25 点此下载全文 |
| 引用本文：陈国平,江建中,谢兆林,甘锋平,黄圣斌,林鑫欣,李颖.术中电生理监测在儿童肘部骨折合并尺神经损伤中的应用[J].医学研究杂志,2018,47(7):91-95 |
| DOI：
10.11969/j.issn.1673-548X.2018.07.022 |
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| 基金项目:广西壮族自治区贵港市科学研究与技术开发计划项目（1302015） |
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| 中文摘要:目的 探究电生理检测在儿童肘部骨折术并尺神经损伤神经松懈术中的应用。方法 选取笔者医院治疗的58例肘部骨折患儿，以及同期在笔者院进行体检上肢正常的30例正常儿童为正常组，采用肌电图仪对所有研究对象腕部~肘下部、肘下部~肘上部进行神经电生理检测。采用随机数字表法将患儿分为对照组、观察组（每组29例），记录观察组神经松懈前后运动神经传导速度（MCV）、感觉神经传导速度（SCV）、潜伏期与诱发电位波幅变化，术后对两组患者肘关节功能以及上肢神经恢复功能进行评定。结果 患儿患侧MCV、SCV低于正常儿童、患儿健侧，差异有统计学意义（P<0.05）。患侧中有2例（3.45%） MCV、SCV在正常范围内，其余56例（96.55%） MCV、SCV均明显降低。电生理检测显示，与神经松懈术前对比，松懈后即刻、3、5、7min MCV升高，潜伏期缩短，差异有统计学意义（P<0.05）。松懈前后波幅比较，差异无统计学意义（P>0.05）。观察组肘关节功能评分、神经功能评分高于对照组，差异有统计学意义（P<0.05）。观察组术后综合疗效高于对照组，但差异无统计学意义（P>0.05）。Pearson相关性分析显示，MCV与患者术后治疗效果呈显著正相关（r=0.857，P=0.000）。结论 术中电生理检测MCV能够体现肘部骨折合并尺神经损伤患儿术后神经功能恢复效果，可作为儿童肘部骨折合并尺神经损伤预后评估指标。 |
| 中文关键词:肘部骨折 电生理检测 运动神经传导速度 效果 |
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| Application of Intraoperative Electrophysiological Monitoring in Children with Elbow Fracture and Ulnar Nerve Injury |
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| Abstract:Objective To explore the application of intraoperative electrophysiological monitoring in children with elbow fracture and ulnar nerve injury. Methods Totally 58 cases of children with elbow fracture treated in our hospital and 30 cases of healthy children of normal physical examination in the same period as the normal group were selected as the study objects. Wrist to lower elbow, lower elbow to upper elbow of children and normal children were detected by Electromyogram apparatus. The children were divided into the control group and the observation group by random digital expression method,29 cases in each group, accroding to random number table method. Motor nerve conduction velocity (MCV) before and after nerve relaxation in the observation group, incubation period and evoked potential amplitude changes were recorded, and after operation, elbow function and upper limb nerve recovery function were evaluated in the two groups. Results MCV, SCV in the affected side of the children were lower than those in the normal children and the healthy side of the children, with statistically significant differences (P<0.05). In the affected side, there were 2 cases (3.45%) of MCV and SCV in the normal range, and the other 56 cases (96.55%) of MCV and SCV decreased significantly. Intraoperative electrophysiological examination showed when compared with that at relaxation of nerve before operation, MCV increased immediately after relaxation, 3, 5, 7min, and incubation period shortened, with statistically significant differences (P<0.05). There was no significant difference between the amplitude and the amplitude before and after relaxation (P>0.05). The elbow function score and neurological function score of the observation group were higher than that of the control group, the difference was statistically significant (P<0.05). The comprehensive effect of the observation group was higher than that of the control group, but the difference was not statistically significant (P>0.05).Pearson correlation analysis showed MCV was significantly positive-correlated with postoperative treatment effect (r=0.857,P=0.000). Conclusion MCV by intraoperative electrophysiological detection can reflect the recovery effect of children with elbow fracture and ulnar nerve injury after operation. It can be used as a prognostic index for children with elbow fracture and ulnar nerve injury. |
| keywords:Elbow fracture Electrophysiological detection Motor nerve conduction velocity Effect |
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