- 期刊
小兒麻痺患者正中神經之感覺神經遠端潛伏期
Distal Sensory Latency of Median Nerve in Poliomyelitis Patients
摘要
本研究的目的是在探討小兒麻痺患者長期使用拐杖後，他們的正中神經是否會有較長的感覺神經遠端潛伏期(distal sensory latency以下簡稱DSL)，並藉此推論其正中神經感覺傳導異常的比率。研究對象分成三組：I，用拐杖的小兒麻痺患者34名；II，不用拐杖的小兒麻痺患者主5名；III，正常人21名。各組的年齡分佈大略相同，從21歲到36歲，平均都是27歲。以肌電圖儀器檢測受試者兩手正中感覺神經的遠端潛伏期(DSL)，所測得的DSL如果大於3.40msec，則認定該受試者的正中神經感覺傳導異常。結果發現，小兒麻痺患者長期使用拐杖後，正中神經的DSL會明顯地延長，同時正中神經感覺傳導異常的比率偏高；此外，便用拐杖愈久者，其正中神經感覺傳導異常的比率也偏高。我們也發使用前臂拐杖患者，其正中神經感覺傳導異常的比率高於腋下拐杖使用者。
關鍵字
無資料並列摘要
It has benn recognized that overuse of wrist may induce abnormal median nerve. Most of the poliomyelitis patients compensate the weakness of the lower extremities by overusing their upper extremities, so that they were expected to have a higher incidence of abnormal median nerve. Totally 70 cases including 24 men and 46 women attended for this study. They were divided into three groups: group I , 34 poliomyelitis patients who used crutches; group II ,15 poliomyelitis patients who did not use crutches; group III , 21 normal control. The mean ages were 27.6 years in group I , 26.5 years in group II and 27.3 years in group III . Under the room temperature of 23-25 °C , distal sensory latency (DSL) measured by an antidromic method and fixed at 14cm from wrist to index finger were investigated in bilateral median nerves for each case. The results showed DSL was 2.92±0.49msec in group I . 2.66±0.36msec in group II and 2.42±0.31msec in group III . An abnormal median nerve was highly suspected in a prolonged DSL longer than the upper normal limit of 3.4msec. Both poliomyelitis patients groups had significantly prolonged distal sensory latency (group I vs group III , p＜0.01; group II vs group III, p＜0.05). The incidence of abnormal median nerve was 14.7% in group I , 6.7% in group II and 0% in group III . It meant that crutch-using group had a higher incidence of abnormal median nerve. Furthermore, according to the duration of crutch-using, group I was divided into three subgroups: group A, 2 cases (4 hands), using the crutches less than 10 years; group B, 17 cases (34 hands), using the crutches for 10-20 years; group C, 15 cases (30 hands), using the crutches more than 20 years. The incidence of abnormal median nerve of each subgroup was: group A, 0%; group B, 8.8% (3/34 hands), group C, 23.3% (7/30 hands). It indicates the longer they used crutches, the higher incidence they got abnormal median nerve. In addition, Lofstrand crutch users had a higher incidence of abnormal median nerve than axillary-crutch users (p＜0.05).