DIAGNOSTIC-VALUE OF QUANTITATIVE SENSORY TESTING (QST) IN CARPAL-TUNNEL SYNDROME
DIAGNOSTIC-VALUE OF QUANTITATIVE SENSORY TESTING (QST) IN CARPAL-TUNNEL SYNDROME
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DOI：
10.1111/j.1600-0404.1988.tb03698.x
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发表时间：
1988-12-01
影响因子：
3.5
通讯作者：
LINDBLOM, U
中科院分区：
文献类型：
--
作者：
BORG, K;LINDBLOM, U
腕管综合征（CTS）最初的感觉症状通常是间歇性的，临床神经学检查通常正常。本研究的目的是通过以下测试来确定CTS不同体感模式的损害率：振动、触觉脉冲、冯弗雷毛、两点辨别（2-PD）、图形感觉和冷暖感知阈值。材料包括来自22例CTS患者的33只手。前3项检查均异常，17只CTS手（52%）阈值升高，10只2-PD手（30%）异常，8只手（24%）异常，只有5只手（15%）出现冷热阈值异常。存在重叠，因此33只CTS手中有27只（82%）至少有一项测试异常。因此，如果应用多个测试，可以在大多数CTS患者中证明敏感性损害。建议使用振动仪和von Frey毛发代替常用的2-PD，因为异常更容易被发现，而且它们同样容易应用。当手处于静止位置时，没有一个单独的测试对质量足够敏感，作为诊断标准。如果与刺激相结合，任何测试的灵敏度和特异性都可以显著增加，例如手腕屈曲，正如振动测量所证明的那样(1)。
The initial sensory symptoms of carpal tunnel syndrome (CTS) are usually intermittent and the clinical neurological examination is often normal. The aim of the present study was to determine the rate of impairment of different somatosensory modalities in CTS by means of the following tests: vibrametry, tactile pulses, von Frey hairs, two-point discrimination (2-PD), graphesthesia and warm and cold perception thresholds. The material consisted of 33 hands with CTS from 22 patients. Each of the first 3 tests was abnormal with elevated thresholds in 17 CTS hands (52%), 2-PD was abnormal in 10 hands (30%), graphesthesia in 8 hands (24%), and warm and cold thresholds in only 5 hands (15%). There was an overlap so that at least one test was abnormal in 27 of the 33 CTS hands (82%). Thus, impairment of sensibility can be demonstrated in a majority of patients with CTS if more than one test is applied. Vibrametry and von Frey hairs are recommended instead of the commonly used 2-PD, since abnormality was more often revealed and since they are equally easy to apply. No individual test was sensitive enough to quality as a diagnostic criterion when it was applied with the hand in resting position. A significant increase in both sensitivity and specificity can be expected for any test if it is combined with provocation, such as wrist flexion, as has been demonstrated for vibrametry (1).