高分辨力超声对糖尿病合并腕管综合征诊断价值的研究

目的通过高分辨力超声对糖尿病合并腕管综合征正中神经横截面积的测量,探讨高分辨力超声对糖尿病合并腕管综合征的诊断价值.方法以就诊的80例患者为研究对象,经检测发现,Ⅱ型糖尿病组患者(DM)30例,非Ⅱ型糖尿病组患者(non-DM)50例.进一步经过临床表现、查体及电生理检查发现,DM组的60只手腕中有32只CTS手腕,而non-DM组的100只手腕中有58只CTS手腕.因此,本研究根据同一时期来医院检查身体的30例正常人的60只手腕设为对照组,即A组;80例患者分为3个实验组,分别为B组:58只non-DM组的CTS手腕(CTS);C组:28只DM组的非CTS手腕(DM组);D组:32只DM组的CTS手腕(DM-CTS).于豌豆骨水平及钩骨钩水平分别测量并比较上述4个实验组的正中神经CSA值,分析评价各组间的统计学差异,得出相应结论.结果 1)CTS组及DM合并CTS组的正中神经豌豆骨水平及钩骨钩水平的CSA值均较对照组及DM组增大(P0.05);2)DM组的正中神经豌豆骨水平及钩骨钩水平CSA值较对照组相比增大(P0.05);3)单纯CTS组的正中神经豌豆骨和钩骨钩水平的CSA值较DM组(不合并CTS)增大(P0.05);4)DM合并CTS实验组的正中神经豌豆骨水平及钩骨钩水平的CSA值与CTS组相比无显著性差别(P0.05).结论高分辨力超声对于腕管综合征、合并糖尿病的腕管综合征的临床诊断有一定价值,可为临床提供参考.

Diagnostic Values of High-Resolution Ultrasonography in Carpal Tunnel Syndrome with Diabetes Mellitus

ObjectiveTo investigate the diagnostic value of high resolution ultrasonography in the diagnosis of carpal tunnel syndrome (CTS) complicated with diabetes mellitus by measuring the CSA of the median nerve.Method80 patients with CTS were observed,including 30 patients with type 2 diabetes mellitus (DM group) and 50 non-diabetic patients(non-DM group).The clinical manifestation,physical examination and electrophysiological test showed that there were 32 wrists suffering from CTS in 60 wrists in DM group and 58 wrists suffering from CTS in 100 wrists in non-DM group.Therefore,60 hands of 30 normal healthy volunteers for physical examination were chosen as controls,namely group A;the 80 cases were divided into three groups,group B:58 CTS wrists of non-DM patients;group C:28 DM-wrists without CTS;group D:32 DM and CTS-wrists DM-CTS.CSA values of the median nerve were measured and compared at the level of pisiform bone and unciforme among the four groups,respectively.The conclusion was made by evaluating the differences between the groups statistically.Results 1) The CSA values of the median nerve at the level of pisiform bone and unciforme in CTS group and DM-CTS group were larger than those in the control group and DM group significantly;2) The CSA values of the median nerve at the level of pisiform bone and unciforme in DM group were larger than those in the control group;3) The CSA values of the median nerve at the level of pisiform bone and unciforme in CTS group were larger than those in DM group (without CTS);4) The CSA values of the median nerve at the level of pisiform bone and unciforme DM-CTS group were not significantly different from those in CTS group.ConclusionHigh-resolution ultrasound has a certain value in the clinical diagnosis of carpal tunnel syndrome and diabetic patients with carpal tunnel syndrome,and the study may provide a reference for its clinical application.