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The Change of Electromyography Before and after Ulnar Nerve Release

Author: GuLiBaHaEr·WuBuLi
Tutor: AiHeMaiTiJiang·YuSuFu
School: Xinjiang Medical University
Course: Surgery
Keywords: Intraop erative monitorin g Electrophysiology Cubital tunnel syndrome
CLC: R688
Type: Master's thesis
Year: 2011
Downloads: 3
Quote: 0
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Abstract


Objectives: Through to cubital tunnel syndrome patients with EMG detection before operation, the operation admission releasable before peration, after neurolysis and nerve conduction velocity(Never Conduction Velocity, NCV)and other changes, and analysis of preoperative neurophysiological indices and severity of illness, operation treatment efficacy of correlation, in order to explore the EMG detection in the diagnosis of cubital tunnel syndrome, therapeutic application of guiding significance for the early diagnosis of cubital tunnel syndrome, the disease, improved operation treatment method and eventually reduce the operation, improve the prognosis of traumatic operation to provide a scientific basis.Methods: from 2010 July to 2011 July, selected in the first affiliated hospital of Xinjiang Medical University microsurgical repair and reconstruction of ulnar nerve neurolysis in parallel preamplifier for treatment of cubital tunnel syndrome patients and this period in Huashan Hospital Affiliated to Fudan University of Shanghai hand surgery hospital anterior transposition of ulnar nerve neurolysis parallel treatment of cubital tunnel syndrome with 45 cases as the research object, using EMG detection means through: (1)a group of independent samples test and Spearman rank correlation comparison in patients with preoperative EMG detection measured ulnar nerve motor nerve conduction velocity, latency, amplitude and normal level difference and the analysis of the indexes and the disease severity; (2)using the micro shift technology orientation method detection of entrapment sites and to compare it with intraoperative observed actual entrapment sites to evaluate preoperative EMG detection and location accuracy of diagnosis; (3)application of paired test, analysis of neurolysis pretest to posttest ulnar nerve conduction velocity, the latency and the amplitude change of situation, these two operation on the ulnar nerve of short-term functional recovery; (4)the evaluation of postoperative short term efficacy(March)and preoperative ulnar nerve conduction velocity, incubation period And the amplitude correlation, ultimately to the evaluation of neurophysiological monitoring in the diagnosis of cubital tunnel syndrome, treatment of guiding significance.Results: 38 in 45 cases were postoperative March to obtain short-term follow-up, follow-up rate was 84. 4%. No long-term follow-up; 1. 38 cases study of ulnar nerve conduction velocity, the latency and the amplitude average values were: 24.52+11.43 (M/s), 10.68+6.51(MS)and 3.42+3.17(MV); compared with normal subjects, patients with cubital tunnel syndrome ulnar nerve conduction velocity slowing, prolongation of latency, amplitude decreased. 2 ulnar nerve conduction velocity and wave amplitude and disease severity correlated negatively, and latency and disease severity was positively related to. 3 EMG detection in micro shift technology orientation method in detection of cubital tunnel syndrome entrapment sites of correct localization rate reached 83. 64%, once again proved that the technology in the cubital tunnel syndrome application advantage. 4 after neurolysis, ulnar nerve conduction velocity is non-releasable front increased quickly, latency is releasable before shortening, fluctuation is non-releasable front elevation. Severe cubital tunnel syndrome showed no statistically significant differences between the various indicators, moderate cubital tunnel syndrome indicators in the motor conduction velocity differences have statistical significance, but no significant changes in amplitude and latency, mild cubital tunnel syndrome indicators are highly statistically significant, 5 postoperative March evaluation of efficacy, the majority of patients 78.94% to obtain a more satisfactory the efficacy(or curative effect in 14 cases, good in 14 cases), but there are still a few people(10.53%)poor efficacy.Conclusion: (1)preoperative application of EMG examination technology is helpful to the diagnosis of cubital tunnel syndrome, judging the disease severity and prognosis, and allows for a more accurate preoperative site of lesion location; (2)for releasable upon available EMG detection of ulnar nerve function improvement, can directly objective early judgment of operation solution effect, (3)the cubital tunnel syndrome patients with operation curative effect of preoperative degree of nerve injury, in severe cubital tunnel syndrome after operation for releasable if electrophysiological detection index did not change significantly prompt the clinician can be simultaneously performed function reconstruction.(4)as a simple, noninvasive, objective check method, electrophysiological examination for patients and clinicians to provide the real basis, on postoperative rehabilitation guidance, should be in the cubital tunnel syndrome diagnosis and treatment is widely used.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery )
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