[用于诊断腕管综合征的神经造影术]
[Neurography for diagnosing carpal tunnel syndrome].
作者信息
Todnem Kari, Sand Trond
机构信息
Avdeling for nevrologi og klinisk nevrofysiologi, St. Olavs hospital, Norway.
出版信息
Tidsskr Nor Laegeforen. 2013 Jan 22;133(2):170-3. doi: 10.4045/tidsskr.12.0103.
BACKGROUND
A number of evidence-based guidelines now recommend that a nerve conduction study should be used to confirm the existence of carpal tunnel syndrome before any surgery takes place.
METHOD
The article is based on a search in PubMed, a personal literature archive (1980-2011) and long clinical experience of neurological and neurophysiological diagnostics.
RESULTS
Both motor and sensory nerve fascicles must be tested after adequate warming up. An extended nerve conduction study with supplementary tests to compare velocities and latencies in median and ulnar nerves, increases the diagnostic precision. Given normal or mild findings, surgery can usually be avoided as the first choice of treatment, because many patients with mild carpal tunnel syndrome recover spontaneously.
INTERPRETATION
The gold standard for diagnosis of carpal tunnel syndrome should be a combination of a clinical examination and a nerve conduction study.
背景
现在许多循证指南推荐，在进行任何手术之前，应使用神经传导研究来确认腕管综合征的存在。
方法
本文基于对PubMed、个人文献存档（1980 - 2011年）的检索以及神经学和神经生理学诊断方面的长期临床经验。
结果
在充分热身之后，必须对运动和感觉神经束进行测试。进行扩展的神经传导研究并辅以比较正中神经和尺神经速度及潜伏期的测试，可提高诊断精度。若检查结果正常或为轻度，通常可避免将手术作为首选治疗方法，因为许多轻度腕管综合征患者可自行康复。
解读
腕管综合征诊断的金标准应为临床检查与神经传导研究相结合。
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