摘要
目的 基于神经电生理检查评估基底节卒中恢复期患者上肢感觉和运动功能情况,探讨周围神经损伤与感觉功能障碍的关系。方法 选取2021-06—2022-09符合条件的56例基底节卒中患者,行上肢运动神经传导、感觉神经传导、F波、体感诱发电位(SEP)检查,记录患者的一般资料,采用Fugl-Meyer上肢评定量表评定上肢运动功能,Semmes-Weinstein单丝和两点辨别工具分别测试患者手的单丝触觉和两点辨别觉,采用偏瘫手实用能力分级评估患者的手实用功能。根据SEP N20是否异常分为SEP正常组和SEP异常组,比较2组患者的感觉、运动功能以及周围神经传导参数。结果 34例SEP异常组以脑出血(P<0.05)为主,上肢和手Brunnstrom分期低于正常组(P<0.001),偏瘫手实用能力分级低于正常组(P<0.001),单丝触觉和两点辨别觉功能较正常组差(P<0.001)。SEP异常组N9潜伏期较正常组低(P<0.05)。SEP异常组偏瘫侧周围神经传导功能较正常组低,正中神经混合肌肉动作电位(CMAP)波幅,尺神经CMAP潜伏期、波幅明显降低(P<0.05);正中神经感觉神经电位(SNAP)波幅,尺神经SNAP潜伏期、波幅及桡神经SNAP潜伏期明显降低(P<0.05)。结论 基底节损伤且有感觉功能障碍的卒中患者周围神经功能较差,临床应多关注感觉障碍患者的周围神经功能,及时发现和治疗。
Objective To evaluate the sensory and motor function of upper limbs in patients with basal gan⁃glia stroke during recovery period based on electrophysiological examination,and to explore the relationship between peripheral nerve injury and sensory dysfunction.Methods From June 2021 to September 2022,56 eligible patients with basal ganglia stroke were selected for upper limb motor nerve conduction,sensory nerve conduction,F wave and somatosensory evoked potential(SEP)examination.The general data of the patients were recorded.The Fugl-Meyer upper limb rating scale was used to evaluate the upper limb motor function.Semmes-Weinstein monofilament and two-point discrimination tools were used to test the monofilament touch and two-point discrimination of the patients’hands.The hand practical function of patients was evaluated by grading the practical ability of hemiplegic hand.Ac⁃cording to whether SEP N20 was abnormal,the patients were divided into SEP normal group and SEP abnormal group.The differences of sensory,motor function and peripheral nerve conduction parameters between the two groups were compared.Results The 34 patients with abnormal SEP were mainly cerebral hemorrhage(P<0.05).The Brunnstrom stage of upper limbs and hands was lower than that of the normal group(P<0.001).The practical ability of hemiplegic hands was lower than that of the normal group(P<0.001).The latency of N9 in abnormal SEP group was lower than that in normal group(P<0.05).The conduction function of peripheral nerve in the hemiplegic side in the abnormal SEP group was lower than that in the normal group.The compound muscle action potential(CMAP)am⁃plitude of median nerve and the latency and amplitude of CMAP of ulnar nerve were significantly decreased(P<0.05).The amplitude of sensory nerve action potential(SNAP)of median nerve,the latency and amplitude of ulnar nerve SNAP,and the latency of radial nerve SNAP were significantly decreased(P<0.05).Conclusion Peripheral nerve function is poor in basal ganglia stroke patients with sensory dysfunction.Clinically,more attention should be paid to the peripheral nerve function of patients with sensory disorders,timely detection and treatment.
作者
刘煜
马将
李红
赵青青
史万英
陶晓琳
郭立颖
刘先莹
杨世宁
杨茜
白云飞
LIU Yu;MA Jiang;LI Hong;ZHAO Qingqing;SHI Wanying;TAO Xiaolin;GUO Liying;LIU Xianying;YANG Shining;YANG Qian;BAI Yunfei(Jianhua Hospital of Shijiazhuang People’s Hospital,Shijiazhuang 050030,China;College of Physical Education,Hebei Normal University,Shijiazhuang 050024,China;College of Nursing and Rehabilitation,North China University of Technology,Shijiazhuang 063210,China)
出处
《中国实用神经疾病杂志》
2023年第6期719-724,共6页
Chinese Journal of Practical Nervous Diseases
关键词
脑卒中
基底节
周围神经
神经电生理
体感诱发电位
感觉功能
运动功能
Stroke
Basal ganglia
Peripheral nerve
Electrophysiology
Somatosensory evoked potential
Sensory function
Motor function
