Pierre-Jerome C, Bekkelund S I, Mellgren S I, Torbergsen T
Department of Radiology, University Hospital, Tromsö, Norway.
Scand J Work Environ Health. 1996 Apr;22(2):119-23.
The purpose of this study was to evaluate possible structural changes of the wrist and subclinical damage in the median nerves of healthy floor cleaners.
Twenty-four cleaners and 19 referents (noncleaners), all women, underwent bilateral magnetic resonance (MR) wrist examination and nerve conduction studies. They were all randomly selected from an occupational health service. From MR images the volumes of the wrist, carpal tunnel, and thenar and hypothenar muscles were calculated, as well as the signal intensity of the median nerve, bilaterally.
No significant difference in the volume of the carpal tunnel was found in the two groups. The relative signal intensity of the median nerve was 0.55 for the cleaners and 0.48 for the referents (P = 0.05). The mean nerve conduction velocity values were 55.2 m.s-1 for the right median nerve of the cleaners and 57.4 m.s-1 for the right median nerve of the referents (P = 0.03). The median nerve of the cleaners had a mean sensory amplitude of 128.2 microV compared with 162.8 microV for the referents (P = 0.01). There was a tendency towards a longer distal latency of the median nerve in the cleaner group.
This study revealed subclinical intrinsic damage to the median nerve, as demonstrated by MR, and poorer electrophysiological nerve function among workers at high risk (cleaners) compared with workers at lower risk (noncleaners).
本研究旨在评估健康楼层清洁工手腕可能的结构变化以及正中神经的亚临床损伤。
24名清洁工和19名对照者（非清洁工），均为女性，接受了双侧磁共振（MR）手腕检查和神经传导研究。她们均从职业健康服务机构中随机选取。通过MR图像计算手腕、腕管、大鱼际和小鱼际肌肉的体积，以及双侧正中神经的信号强度。
两组腕管体积无显著差异。清洁工正中神经的相对信号强度为0.55，对照者为0.48（P = 0.05）。清洁工右侧正中神经的平均神经传导速度值为55.2 m·s⁻¹，对照者右侧正中神经为57.4 m·s⁻¹（P = 0.03）。清洁工正中神经的平均感觉振幅为128.2 μV，对照者为162.8 μV（P = 0.01）。清洁工组正中神经的远端潜伏期有延长的趋势。
本研究显示，与低风险工人（非清洁工）相比，高风险工人（清洁工）的正中神经存在MR所示的亚临床内在损伤以及较差的电生理神经功能。
