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电生理BCR ICR PEP检查对马尾综合征的诊断和预后的临床意义 |
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李佩华 吴常德 马忠泰 贺占举 魏增河 穆宏涛
【摘要】目的 通过开展球海绵体肌反射(BCR)、坐骨海绵体肌反射(ICR)及阴部诱发电位(PEP)等电生理检测，评价该技术对伴有马尾神经损伤患者的诊断价值。方法 127例男性均经影像学和手术证实为腰椎间盘突出症及腰椎管狭窄症患者,进行BCR、ICR、PEP检查。另选10例正常受试者进行相同的检查对照。结果 127例患者中,发现异常者59例(46.5％),表现为潜伏期延长或波形消失,提示这些患者已存在不同程度的马尾神经损害。而经临床诊断为马尾神经损害患者只有39例(30.7％),此结果明显高出临床对马尾神经损害的诊断。经χ2检验P<0.005。结论 BCR、ICR、PEP检查能灵敏地、客观地反映马尾神经的功能状态。对马尾综合征患者具有诊断价值,该检查对手术疗效和预测预后也提供了有效的客观指标。
【关键词】反射 诱发电位 诊断 马尾
Clinical Significance of the Electrophysiological Tests of BCR, ICR and PEP in Diagnosis and Prognosis of Cauda Equina Syndrome
LI Peihua,WU Changde, MA Zhongtai, et al.
Department of Orthopaedics Surgery,The First Teaching Hospital of Beijing Medical University, Beijing 100034
【Abstract】 Objective To evaluate the clinical value of the electrophysiological tests of bulbocavernosus reflex (BCR),ischiocavernosus reflex (ICR) and pudenda evoked potential (PEP) in diagnosis of cauda equina injury. Methods BCR, ICR and PEP were performed in 127 males with lumbar disc protrusion and lumbar spinal stenosis. The results were compared with 10 normal controls. Results 59 of 127(46.5％ ) patients had abnormal data, which were more sensitive than clinical findings. BCR, ICR and PEP were either absent or presented with a prolonged latency. Conclusion BCR, ICR and PEP were able to objectively and sensitively reflect the functions of the cauda equina.Therefore, BCR, ICR and PEP were reliable methods for the diagnosis of cauda equina syndrome, and were useful in evaluation of the efficacy of surgical procedure and in prediction of the prognosis. 【Key words】 Reflex Evoked potentials Diagnosis Cauda equina
球海绵体肌反射(bulbocavernosusreflex,BCR),坐骨海绵体肌反射(ischiocavernosus reflex,ICR)和阴部诱发电位(pudendal evoked potential,PEP)是一项评价骶髓、马尾神经和周围神经功能完整性的客观检测方法[1－4]。作者自1994～1997年用该检测手段共检查了300多例各种相关疾病患者,现总结其中127例腰椎间盘突出症及腰椎管狭窄症男性患者资料,试图探讨对马尾综合征的诊断及预测预后的应用价值和临床意义。
资料与方法
男性患者127例,其中腰椎间盘突出[1] [2] 下一页
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