摘要目的 探讨了重度腕管综合征患者术前针极肌电图结果与术后拇短展肌(APB)功能恢复之间的关系.方法 回顾性分析68例(76只手)重度腕管综合征患者的临床资料,依据术前针极肌电图结果进行分组,其中运动单位电位(MUP)阳性组46例(52只手),MUP阴性组22例(24只手).两组患者术后1年进行随访,复查拇短展肌的手法肌力检查(MMT)分级、拇指功能恢复情况和患者术后满意度.结果 MUP阳性组术后1年MMT分级≥3级率、满意和非常满意率明显高于MUP阴性组[100.0%(52/52)比75.0%(18/24)和100.0%(52/52)比66.7%(16/24)],差异有统计学意义(P<0.05).患者术后1年拇指功能通过硬币拾取测试、钮扣紧固试验和缝纫针夹试验进行评估,结果显示MUP阳性组术后拇指功能恢复情况均优于MUP阴性组,差异有统计学意义(P<0.05).结论 拇指术后功能恢复与术前拇短展肌针极肌电图检查是否诱发MUP相关,对于MUP阳性患者在术后1年无需二次拇指对掌成形术,针极肌电图对于施行拇指对掌成形术有一定的参考作用.

abstractsObjective To investigate the relationship between the results of preoperative needle electromyography and the recovery of abductor pollicis brevis (APB) function in patients with severe carpal tunnel syndrome. Methods The clinical data of 68 patients (76 hands) with severe carpal tunnel syndrome were retrospectively analyzed. According to the results of preoperative needle electromyography, the patients were divided into the motor unit potential (MUP) positive group (46 cases, 52 hands), and MUP negative group (22 cases, 24 hands). The patients were followed up 1 year after operation, and the manual muscle testing (MMT) grade of abductor pollicis brevis muscle, functional assessment of thumb and patient satisfaction was recorded. Results The MMT grade ≥ 3 rate and satisfaction rate 1 year after operation in MUP positive group were significantly higher than those in MUP negative group: 100.0% (52/52) vs. 75.0% (18/24) and 100.0% (52/52) vs. 66.7% (16/24), and there were statistical differences (P＜0.05). The patient′s thumb function 1 year after operation was evaluated by coin pickup test, button fastening test and sewing needle clamp test. The results showed that the thumb function in MUP positive group was significantly better than that in MUP negative group, and there was statistical difference (P＜0.05). Conclusions The recovery of postoperative thumb function is related with the evocation MUP of postoperative abductor pollicis brevis needle electromyography. For MUP positive patients, there is no need for secondary thumb opponensplasty 1 year after operation. Needle electromyography has a certain reference value for thumb opponensplasty.