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体感诱发电位和感觉神经电位在产瘫诊治中的意义 |
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宫云霞 张咸中 徐翠英
【摘要】目的探讨体感诱发电位（SEP）和感觉神经电位（SNAP）在诊断产伤所致臂丛神经损伤的性质及程度中的作用。方法对40例产瘫进行SEP和SNAP测定，并探索适合小儿的检测方法。记录电极均用表面电极，根据电生理测定结果作出定位诊断，为术式选择提供依据。结果40例产瘫电生理测定结果中经手术证实与临床符合35例，占87.5％，不符合5例，占12.5％，符合率高，对临床诊断和治疗意义大。结论SEP和SNAP是产瘫术前判断神经损伤性质、程度较可靠的方法，为临床诊断和术式选择提供十分有利的依据。
【关键词】产伤 臂丛 电生理学
Significance of Somatosensory Evoked Potentials and Sensory Nerve Action Potentials in the Diagnosis and Treatment of Obstetric Brachial Plexus Palsy
GONG Yunxia, ZHANG Xianzhong，XU Cuiying.
Department of Hand and Foot Surgery,The People’s Hospital of Jilin Province,Changchun 130021
【Abstract】 Objective Somatosensory evoked potentials (SEP and sensory nerve action potentials(SNAP were used for the judgement of injury type and degree of the obstetric brachial plexus palsy Methods Forty cases of obstetric brachial plexus palsy were studied by SEP and SNAP，the detective method especially suitable for children was explored.The surface electrode was used as recording electrode. Positional diagnosis was made out according to electrophysiological result and provided basis for operative decision.Results In the 40 cases of obstretric brachial plexus palsy examined with SEP and SNAP,the findings were in accord with that seen in the operation in 35 cases.The positive detective rate was 87.5 and the negative was 12.5％.Conclusion SEP and SNAP were more dependable to judge injury type and degree of the obstetric brachial plexus palsy before operation and provided valuable information for clinical diagnosis and surgical decision.
【Key words】 Birth injuries Brachial plexus Electrophysiology
对于产伤性臂丛神经损伤（产瘫）的性质和程度的诊断一直是一个难题，只有正确的诊断，才能给予患儿正确的治疗[1]。受黄绥仁等[2]应用体感诱发电位诊断成人臂丛神经损伤的启发，1994年8月～1997年8月我科对40例产瘫患儿进行体感诱发电位（somatosensory evoked potential,SEP）和感觉神经电位（sensory nerve action potential,SNAP）检测，对产瘫的临床治疗提供了重要依据。
资料与方法
本组患儿40例，男18例，女22例。年龄35天～4岁，平均10个月。左侧19例，右侧21例。上干不全损伤18例，上干完全损伤4例，[1] [2] 下一页
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