【摘要】 目的高频超声测量并计算腕管综合征(CTS)患者腕管豌豆骨水平正中神经横断面积和腕管内受压部位的正中神经横断面积及受压率,评价高频超声对CTS严重程度的诊断价值。方法 2017年2月～2019年12月我院就诊的34例患者63只手腕经临床及神经肌电图确诊为CTS。CTS患者根据肌电图分级诊断分为轻度组26个,中度组21个,重度组16个。超声测量腕横韧带厚度;测量腕管豌豆骨水平正中神经横断面积(CASP)和腕管内正中神经受压部位横断面积(CASC),并计算正中神经受压率RCSA=(CASP-CASC)/CASP。结果三组腕横韧带厚度、CASP、RCSA随着CTS的严重程度的增加而升高,差异有统计学意义(P <0.001);三组CASC随着CTS的严重程度的增加而减小,差异有统计学意义(P <0.001)。CTS的严重程度与腕横韧带、CASP、RCSA之间的相关性分析均为显著性正相关,CTS的严重程度与CASC之间的相关性分析为显著性负相关,相关性均有统计学意义(P <0.001)。结论高频超声测量腕横韧带厚度、CASP、CASC、RCSA对判断CTS患者的严重程度具有重要的价值,其中以RCSA诊断价值更高。更多还原

【Abstract】 Objective To measure and calculate the cross-sectional area of median nerve at pisiform bone level of carpal tunnel and the cross-sectional area and compression rate of median nerve at the compression site in carpal tunnel in the patients with carpal tunnel syndrome(CTS) through high frequency ultrasound, and to evaluate diagnostic value of high frequency ultrasound on the severity of CTS. Methods A total of 63 wrists of 34 patients treated in our hospital from February 2017 to December 2019 were diagnosed with CTS by clinical examination and neuroelectromyography. The patients with CTS were divided into the mild group(n=26), the moderate group(n=21) and the severe group(n=16) according to grading diagnosis of electromyography(EMG). Ultrasonography was used to measure the thickness of transverse carpal ligament. the cross-sectional area of median nerve at pisiform bone level(CSAP) of carpal tunnel and the cross-sectional area of median nerve at the compression site(CSAC) in carpal tunnel were measured, and the compression rate of the median nerve was calculated according to the formula RCSA =(CSAP-CSAC)/CSAP. Results The thickness of transverse carpal ligament, CSAP and RCSA of the three groups increased with the increase of the severity of CTS, with statistically significant differences(P < 0.001). The CSAC in the three groups decreased with the increase of the severity of CTS, and the differences were statistically significant(P < 0.001). The correlation between the severity of CTS and the transverse carpal ligament, CSAP, and RCSA were significantly positive, while the correlation between the severity of CTS and CSAC were significantly negative, with all the correlations being statistically significant(P < 0.001). Conclusion High frequency ultrasound measurement of the thickness of transverse carpal ligament, CSAP, CSAC and RCSA is of great value for judging the severity of the patients with CTS, among which the diagnostic value of RCSA is the greatest.更多还原