Electrophysiological methods on diagnosis of carpal tunnel syndrome and the applied research in the field of occupational medicine

本研究旨在建立腕管综合征（CTS）的早期诊断方法，并将其应用于职业医学领域，检测腕管综合征患者的感觉神经传导速度（SCV-pf，SCV-wf，SCV-wp，SCV-pf，SCV-wp），对27名19-37岁女性手术人员和19名健康女性进行了右侧正中神经SCV-we段和SCV-we段神经传导速度分布的测定此外，计算WF/PF比率，将SCV-wf除以SCV-pf，以评估腕管内神经传导的异常。操作人员在VDT前从事数据录入工作，工作时间为1 ~ 17年，平均6年。作业工人SCV-wf、SCV-wp和WF/PF比值均显著低于对照组。WF/PF比率低于90%的人的比率，即，在19个对照组中，低于正常限值的百分比在操作员组（37%）中显著高于对照组（0%）。与对照组相比，术者抱怨与CTS相关的症状更多，但任何症状均与术者神经传导速度减慢无关。在对照组中，WF/PF比值与皮肤温度或年龄并不密切相关，尽管皮肤温度与SCV-wf，SCV-pf和SCV-wp之间存在显着关系; WF/PF比值的人际变异性远小于所有SCV。根据目前和以前的研究，VDT操作员亚临床CTS的发生率似乎很高，与其症状无关。此外，WF/PF比值将是一个有用的和可靠的筛选方法，用于早期检测CTS由于重复的手腕和手指运动参与工作。

The objective of this study is to develop a diagnostic method for the early detection of carpal tunnel syndrome (CTS), and to apply the technique to the field of occupational medicine.Sensory nerve conduction velocities in the palm-to-finger (SCV-pf), wrist-to finger (SCV-wf), wrist-to-palm (SCV-wp), and wrist-to-elbow (SCV-we) segments and the distribution of nerve conduction velocities in the right median nerve were determined among 27 female operators aged 19-37 and 19 healthy women (controls) aged 19-31 to estimate the prevalence of subclinical CTS.Also, the WF/PF ratio, dividing the SCV-wf by the SCV-pf, was calculated to assess abnormalities of nerve conduction within the carpal tunnel. The operators were engaged in data entry in front of a visual display terminal (VDT) for about 6h/day, and their working duration was between 1 and 17 (mean 6) years. The SCV-wf, SCV-wp, and WF/PF ratio in the operators were significantly lower than those in the controls. The rate of persons with the WF/PF ratio of less than 90%, i.e., below normal limits in the 19 controls, was significantly higher in the operator group (37%) than in the control group (0%). The operators complained of more symptoms related to CTS than did the controls, but any symptoms were not associated with slowing of nerve conduction velocities in the operators. In the controls, the WF/PF ratio was not closely correlated with skin temperature or age despite the presence of significant relations between skin temperature and the SCV-wf, SCV-pf, and SCV-wp ; the interpersonal variability of the WF/PF ratio was much smaller than that of all SCVs. In the light of the present and previous studies, the rate of VDT operators with subclinical CTS seems to be high, independent of its symptoms. Also, the WF/PF ratio will be a useful and reliable screening method for the early detection of CTS due to repetitive wrist and finger movements involved in work.