【摘要】 目的对腕管综合征病人(CTS)进行定量感觉测试(QST)研究,了解CTS病人是否存在小神经纤维的损害并客观评价其感觉障碍的程度。方法对19例临床及常规肌电图及神经传导速度检查证实的CTS病人(共34只手)检测其第2指、3指、5指的温度觉及振动觉。结果患者组第2指、3指、5指的温度觉及振动觉阈值与正常对照组之间存在显著性差异,第2指、3指温度觉异常率在12%~35%之间,振动觉的异常率分别为26%和24%。振动觉的测试结果与神经传导速度之间有很好的相关性。结论应用QST测试可以发现CTS病人存在小神经纤维的损害。QST对于CTS的早期诊断价值不如肌电图-神经传导速度(EMG~NCV)敏感,但可较客观的评价小纤维损害的程度,两者结合,可以对周围神经病变作出全面的评价。更多还原

【Abstract】 Objective The function of sensory nerve fibers in Carpal Tunnel Syndroms(CTS) was evaluated using QST. To demonstrate the impairment of small fibers in CTS, and to establish the diagnostic value of QST for CTS detection. Methods The finger palm of digit 2, digit 3 and digit 5 was tested in 19 cases with CTS (totally, 34 hands). Thresholds for thermal (include of cold, warm, cold pain, heat pain) and vibration were recorded. Results Thermal thresholds and vibration thresholds (VT) on digit 2, digit 3 and digit 5 were significantly difference between CTS group and control subjects (p<0.05). Abnormal proportion of thermal thresholds on digit 2 and digit 3 was 12%～35%, VT was 26% and 24%, respectively. A good correlation between VT on digit 2, digit 3 and SCV, DML of the median nerve at wrist was found. Conclusions QST could found the impairment of small sensory fibers in CTS. Early screening for CTS with QST appeared to offer little benefit over EMG-NCV, but QST could determinate the degree of impairment of sensory fibers along illness, especially in evaluating the function of small sensory fibers. Combining QST with EMG-NCV could give a comprehensive evaluation of peripheral nerve function.更多还原