临床评估是否足以诊断肘管综合征

A. Cirakli, Y. Ekinci, E. Ulusoy, Erdal Uzun
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引用次数: 1

摘要

目的:探讨临床病史和神经学检查对肘管综合征的诊断价值。材料与方法:对2009年1月至2016年1月间临床初步诊断为肘管综合征的128例经肌电图治疗的132条肢体进行评价。根据性别、受累侧和肌电图结果对患者进行评估,以评估是否存在神经病变。所得数据采用Kormogonov-Smirnov检验和Shapiro-Wilk检验进行统计学分析。结果:男性70例(54%),女性58例(46%),平均年龄40.25±12.66岁。经肌电图初步诊断为神经病变的患者中,70例(53%)右肢受累,62例(47%)左肢受累。4例为双侧症状。43例(32.6%)患者(男性27例,女性16例)出现神经病变。其中23例(53.5%)为左侧肢体,20例(46.5%)为右侧肢体,30例患者年龄在30-60岁之间。结论:根据我们的研究结果,我们发现病史和神经学检查对肘管综合征的诊断效率较低。这可能与神经系统检查和病史的相对主观评价以及许多病理在肘管综合征的鉴别诊断中有关。我们认为,对于肘管综合征,除了详细的体格检查外,还需要脊髓电图的应用,以避免延误诊断和不完整/不正确的治疗。
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Is clinical evaluation sufficient enough to diagnose the cubital tunnel syndrome
Aim: The aim of the study was to determine the diagnostic value of clinical history and neurological examination for cubital tunnel syndrome. Materials and Methods: 132 limbs of 128 patients treated with electromyography with a preliminary clinical diagnosis of cubital tunnel syndrome between the years of January 2009 and January 2016 were evaluated. Patients were evaluated according to gender, affected side and electromyography results to assess the presence of neuropathy. The obtained data were statistically analyzed by Kormogonov-Smirnov and Shapiro-Wilk test. Results: 70 patients (54%) were male and 58 (46%) were female and the average age was 40.25±12.66. The affected side was right extremity in 70 (53%) of cases and left extremity in 62 (47%) who underwent electromyography with a preliminary diagnosis of neuropathy. Symptoms were bilateral in 4 cases. As a result of electromyography 43 (32.6%) (27 male, 16 female) patients had neuropathy. Affected side in 23 of these patients (53.5%) was left limb and 20 (46.5%) was right limb and 30 of involved patients were in the range of 30-60 years. Conclusion: According to the results of our study, we found that history and neurological examination have a low efficiency in the diagnosis of cubital tunnel syndrome. This may be associated with relatively subjective evaluation of neurological examination and history and also many pathologies in the differential diagnosis of cubital tunnel syndrome. We believe that electromyelography application is required in addition to a detailed physical examination for cubital tunnel syndrome in order to avoid delayed diagnosis and incomplete/incorrect treatment.
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