高频超声检测偏瘫继发肩-手综合征患者正中神经的临床应用

2016-09-19杨阳，李钦

中国中西医结合影像学杂志 2016年5期

关键词：康复检测

杨　阳，李　钦

（新疆乌鲁木齐市第四人民医院温泉分院①医技科，②康复科，新疆乌鲁木齐 830017）

高频超声检测偏瘫继发肩-手综合征患者正中神经的临床应用

杨阳1，李钦2

（新疆乌鲁木齐市第四人民医院温泉分院①医技科，②康复科，新疆乌鲁木齐 830017）

目的：探讨高频超声在偏瘫继发肩-手综合征患者正中神经检测中的临床应用价值。方法：对50例偏瘫继发肩-手综合征患者健、患侧上臂及腕管正中神经的前后径和横截面积进行测量，并与临床分期和患侧肌力影响因素进行对照研究。结果：患者患侧正中神经的前后径和横截面积随着肩-手综合征临床分期加重变窄、缩小明显。随着患侧肌力恢复，正中神经直径及横截面积变大，差异有统计学意义（P＜0.05）。结论：高频超声能清晰显示偏瘫继发肩-手综合征患者的正中神经，并检测到正中神经在形态学上的变化，可评价康复治疗的效果。

超声检查；偏瘫；反射性交感神经营养障碍；正中神经

［Abstract］Objective：To investigate the clinical application of high-frequency ultrasonography in the detection of median nerve of hemiplegia-secondary shoulder-hand syndrome patients.Methods：The anteroposterior diameter and cross-sectional area of median nerve in the upper arm and carpal tunnel of healthy and affected side of 50 hemiplegia-secondary shoulder-hand patients were measured，and the clinical stages and muscle strength were analyzed comparatively.Results：As shoulder-hand syndrome clinical stage increased significantly，the anteroposterior diameter and cross-sectional area of median nerve in the affected side of patients became narrow obviously；with the muscle strength of the affected side recovered，the median nerve diameter and cross-sectional area increased，but not obviously.The difference was statistically significant（P＜0.05）.Conclusions：High-frequency ultrasound can clearly display the median nerve of hemiplegia-secondary shoulder-hand syndrome patients，can detect the morphological changes of median nerve，and can provide a reliable basis for the evaluation of rehabilitation effect.

［Key words］Ultrasonography；Hemiplegia；Reflex sympathetic dystropy；Median nerve

肩-手综合征是偏瘫后突然出现的手肿胀、疼痛的继发性并发症，其发病率占偏瘫患者的12.5%～27.0%［1］。本研究通过使用高频超声检测肩-手综合征患者健、患侧上肢正中神经的横截面积及前后径，探讨超声在偏瘫继发肩-手综合征患者周围神经检测方面的临床应用。