摘要
目的通过颈椎病脊髓病手早期特征性临床表现的分级研究,评价其对早期诊断脊髓型颈椎病的价值。方法分析2007年1月至2012年12月于长征医院及闸北分院骨科收治脊髓型颈椎病患者105例,诊断脊髓病手并进行分级;分析脊髓病手＂手指逃离征＂的肌电图表现,分析分级程度对应肌电图尺神经传导速度及F反应相互关系;采用Pearson相关统计分析10 s握拳-伸指试验次数与肌电图尺神经传导速度的相关性;采用二样本无数比较的t检验对比分析脊髓病手早期诊断组和进展期诊断组JOA评分差异。结果当＂手指逃离征＂为0级时肌电图表现未见明显异常,随着分级增高,肌电图异常表现逐步增多。10 s握拳-伸指次数越高时,尺神经运动传导速度也越快,两者Pearson相关系数为0.46~0.58,呈正相关。脊髓病手早期诊断组和进展期诊断组JOA评分差异具有统计学意义（P〈0.05）。结论 ＂手指逃离征＂可能较肌电图更具早期诊断意义,脊髓病手的分级研究有利于早期诊断脊髓型颈椎病,提高临床诊治效果。
Objective To evaluate the classification of myelopathy hand in early diagnosis of cervical spondylotic myelopathy（ CSM）. Methods One hundred and five patients with cervical spondylotic myelopathy admitted in Changzheng Hospital and Zhabei Branch from January 2007 to December 2012 were enrolled in the study. The myelopathy hand was classified by using finger escape sign and 10-s grip and release test of fist,combined with the electromyography. The relationship of the finger escape sign and electromyography of ill limb was analyzed and the relationship of 10-s grip and release test and the ulnar nerve conduction velocity was also analyzed. The difference of JOA scores between early and advanced myelopathy hand was analyzed by T-test with SPSS statistical software 13. 0. Results The diagnostic indicators of early myelopathy hand： the grade of finger escape signs were 0-1,the number of grip and release test in 10-s was 15 to 20,upper limb electromyography showed neurogenic damage,the hand rest position changes slightly,the interdigital space was widened,the flexion angle of articulations interphalangeae increased. There was significant difference in JOA scores between early and advanced myelopathy hand. Conclusion ＂Finger escape sign ＂ is more important than electromyogram abnormity for the early diagnosis of myelopathy hand,which is helpful for early diagnosis of cervical spondylotic myelopathy.
出处
《同济大学学报（医学版）》
CAS
2015年第1期46-49,共4页
Journal of Tongji University(Medical Science)
基金
上海市卫生局青年科研项目(20114y140)
上海市闸北区科委名学科主攻项目(2011MXKZG01)
关键词
脊髓病手
脊髓型颈椎病
手功能
myelopathy hand
cervical spondylotic myelopathy
hand function
