Gabriel Vincent, Kowalske Karen J, Holavanahalli Radha K
Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas 75390-0955, USA.
J Burn Care Res. 2009 Jul-Aug;30(4):668-74. doi: 10.1097/BCR.0b013e3181abff6a.
The purpose of this study was to investigate the recovery of burn-related neuropathies by electrodiagnostic testing. Burn patients who presented to an American Burn Association verified burn center were interviewed and examined for clinical evidence of peripheral neuropathies by a physiatrist. Patients whom consented to participate were tested for electrodiagnostic evidence of peripheral neuropathy. Repeated studies were performed to assess for evidence of recovery. A total of 370 patients were screened. Thirty-six (9.73%) patients had clinical evidence of neuropathy. Eighteen male patients with a mean TBSA burn of 42% had nerve conduction studies performed. Etiologies of the injuries included eight flame, eight electrical, and three others. Seventy-three nerve conduction studies were performed and 58 of the tests were abnormal. The most commonly affected nerve was the median sensory (10). For patients with repeated tests, the mean time between tests was 169 days (SD, 140 days). There was a significant difference between the initial and follow-up test (McNemar's change test P=.009). In subset analysis of motor and sensory abnormalities, there was no significant difference (P=.07). The most common neuropathy identified in this cohort was the median sensory. Overall, there was improvement in the nerve conduction abnormalities examined. This study suggests that the prognosis for recovery after burn-related neuropathy is good.
本研究的目的是通过电诊断测试来调查烧伤相关神经病变的恢复情况。对前往美国烧伤协会认证的烧伤中心就诊的烧伤患者进行了访谈,并由物理治疗师检查是否有周围神经病变的临床证据。同意参与的患者接受了周围神经病变的电诊断证据检测。进行了重复研究以评估恢复的证据。总共筛查了370名患者。三十六名(9.73%)患者有神经病变的临床证据。对18名平均烧伤总面积为42%的男性患者进行了神经传导研究。损伤原因包括8例火焰烧伤、8例电击伤和3例其他原因。进行了73次神经传导研究,其中58次测试异常。最常受影响的神经是正中感觉神经(10例)。对于进行重复测试的患者,两次测试之间的平均时间为169天(标准差,140天)。初始测试和随访测试之间存在显著差异(McNemar变化检验P = 0.009)。在运动和感觉异常的亚组分析中,没有显著差异(P = 0.07)。该队列中最常见的神经病变是正中感觉神经病变。总体而言,所检查的神经传导异常有所改善。本研究表明,烧伤相关神经病变后的恢复预后良好。