《中国康复理论与实践》

《中国康复理论与实践》 ›› 2013, Vol. 19 ›› Issue (12): 1171-1173.

• 论文 • 上一篇    下一篇

脑卒中后肩-手综合征急性期正中神经传导的变化

余青云，刘爱群，洪铭范，程静，彭忠兴，危智盛   

  1. 广东药学院附属第一医院神经内科，广东广州市510080。
  • 收稿日期:2013-08-09 修回日期:2013-10-25 出版日期:2013-12-25 发布日期:2013-12-25

Changes of Median Nerve Conduction in Acute Stage of Should-Hand Syndrome after Stroke

YU Qing-yun, LIU Ai- qun, HONG Ming- fan, et al.   

  1. Department of Neurology, the First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080,Guangdong, China
  • Received:2013-08-09 Revised:2013-10-25 Published:2013-12-25 Online:2013-12-25

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摘要： 目的观察脑卒中后肩-手综合征(SHS)急性期正中神经传导的变化。方法50 例脑卒中并发SHS 急性期患者(SHS组)、50 例脑卒中无SHS患者(N-SHS组)和50 例无脑卒中无SHS者(N-S组)均行双侧正中神经传导检测(包括感觉、运动神经传导及F波)。结果SHS组患侧正中神经感觉动作电位波幅(SNAP)、复合肌肉动作电位波幅(CMAP)与自身健侧比较均降低(P<0.05)；患侧感觉传导速度(SCV)、末端运动潜伏期(DML)、F 波潜伏期(FL)与健侧比较无显著性差异(P>0.05)；与N-SHS 组、N-S 组比较，SHS组患侧正中神经SCV减慢、SNAP及CMAP减低(P<0.05)；DML、FL 无显著性差异(P>0.05)。结论脑卒中后SHS急性期患侧正中神经受损，以轴索为主，其损伤部位主要在远端，提示正中神经远端的轴索损伤是SHS的一项指标。

关键词: 脑卒中, 肩-手综合征, 正中神经

Abstract: Objective To analyze the changes of nerve conduction of median nerves in acute stage of shoulder-hand syndrome (SHS) after stroke. Methods 50 stroke patients with SHS in the acute stage were selected as SHS group, 50 stroke patients without SHS was selected as N-SHS group, and 50 non-stroke and without SHS patients were selected as N-S group. The detection of bilateral nerve conduction of median nerve included sensory and motor nerve conduction, and F wave. Results In SHS group, the sensory nerve action potential amplitude (SNAP) and compound muscle action potential amplitude (CMAP) of median nerve of the affected hand were lower than that of the unaffected hand (P<0.05). There was no significant difference in sensory conduction velocity (SCV), distal motor latency (DML) and F wave latency of the median nerve between the affected and the unaffected hand in SHS group (P>0.05). The SCV of median nerve was slower, the SNAP and CMAP were lower in SHS group than in N-SHS group and N-S group (P<0.05). There was no significant difference in DML and F wave latency among 3 groups (P>0.05). Conclusion The median nerve on the affected hand is impaired in acute stage of SHS after stroke.The lesion is mostly located in the distal end of median nerve, and is mainly the dystrophy of axonal neuropathy, which indicates that the lesion in the distal segment of median nerve is an essential expression of SHS after stroke.

Key words: stroke, shoulder-hand syndrome, median nerve