Werner R A, Franzblau A, Albers J W, Buchele H, Armstrong T J
Department of Physical Medicine and Rehabilitation, University of Michigan Medical Center, Ann Arbor, USA.
Occup Environ Med. 1997 Feb;54(2):96-100. doi: 10.1136/oem.54.2.96.
To determine if an abnormal sensory nerve conduction study consistent with median mononeuropathy in asymptomatic workers was predictive of future complaints of the hand or finger suggestive of carpal tunnel syndrome.
This was a case-control study of over 700 active workers at five different work sites: four sites involved manufacturing workers and one site represented clerical workers. Patients' reports of symptoms of pain, numbness, tingling, or burning in the hand or finger that lasted more than one week or occurred three or more times after the initial screening were investigated. 77 cases were defined as asymptomatic workers with electrodiagnostic findings of median mononeuropathy in either hand based on a comparison of median and ulnar sensory evoked peak latencies. A difference > or = 0.5 ms was defined as abnormal; a normal difference was < or = 0.2 ms. Controls were asymptomatic age, and sex matched workers with normal nerve conduction studies in both hands. Follow up questionnaires were completed 17 (SD 6) months later.
The follow up participation rate was 72%. Cases had a 12% risk of developing symptoms during the follow up period compared with 10% in the control group, chi 2 = 0.12, P = 0.73.
Abnormal median sensory nerve conduction studies in asymptomatic workers were not predictive of future hand or fingers complaints and if used for preplacement screening among active workers this should be done with caution.
确定在无症状工人中，与正中神经单神经病相符的异常感觉神经传导研究是否能预测未来出现的提示腕管综合征的手部或手指不适。
这是一项对五个不同工作场所的700多名在职工人进行的病例对照研究：四个场所涉及制造业工人，一个场所为文职人员。调查了患者报告的手部或手指疼痛、麻木、刺痛或灼痛症状，这些症状持续超过一周或在初次筛查后出现三次或更多次。根据正中神经和尺神经感觉诱发电位峰值潜伏期的比较，77例被定义为双手电诊断结果为正中神经单神经病的无症状工人。差异≥0.5毫秒被定义为异常；正常差异＜或 = 0.2毫秒。对照组为年龄、性别匹配且双手神经传导研究正常的无症状工人。17（标准差6）个月后完成随访问卷。
随访参与率为72%。病例组在随访期间出现症状的风险为12%，而对照组为10%，χ² = 0.12，P = 0.73。
无症状工人中异常的正中神经感觉神经传导研究不能预测未来的手部或手指不适，如果用于在职工人的入职前筛查，应谨慎进行。
