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

电生理学方法诊断腕管综合征及其在职业医学领域的应用研究

• 批准号: 04670327
• 负责人: MURATA Katsuyuki
• 金额: $ 1.34万
• 依托单位: University of Tokyo
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1992
• 资助国家: 日本
• 起止时间: 1992 至 1993
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-04670327/
• 关键词: Carpal tunnel syndrome; Peripheral nerve conduction velocities; Distribution of nerve conduction velocities; Visual display terminal (VDT) worker; Vibrating tool operator; Electrophysiological methods; Occupational medicine; 電気生理学的診断法; 神経伝導速度分布(DC

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.

本研究的目的是建立一种早期发现腕管综合征的诊断方法，并将该技术应用于职业医学领域。测定27例19-37岁女性手术者和19例19-31岁健康女性（对照组）掌指（SCV-pf）、腕指（SCV-wf）、腕掌（SCV-wp）、腕肘（SCV-we）节段感觉神经传导速度及右侧正中神经传导速度分布，以估计亚临床CTS的患病率。同时，计算WF/PF比率，用SCV-wf除以SCV-pf，评估腕管内神经传导的异常情况。操作员每天在可视显示终端（VDT）前从事数据录入工作约6h，工作时间1 ~ 17年（平均6年）。操作者的SCV-wf、SCV-wp和WF/PF比值显著低于对照组。WF/PF比值小于90%（即在19个对照组中低于正常限值）的患者比例在操作者组（37%）显著高于对照组（0%）。与对照组相比，操作者抱怨与CTS相关的症状更多，但任何症状都与操作者的神经传导速度减慢无关。在对照组中，尽管皮肤温度与SCV-wf、SCV-pf和SCV-wp存在显著关系，但WF/PF比值与皮肤温度或年龄不密切相关；WF/PF比值的人际变异性远小于所有scv。根据目前和以往的研究，VDT手术者亚临床CTS的发生率似乎很高，与症状无关。此外，WF/PF比值将是一种有用和可靠的筛查方法，可以早期发现由于工作中涉及手腕和手指的重复运动而导致的CTS。

项目成果

Murata K,Araki S,Okajima F,Saito Y.: "Subclinical impairment in the median nerve across the carpal tunnel among female VDT operators." International Archives of Occupational and Environmental Health. 68. 75-79 (1996)

Murata K、Araki S、Okajima F、Saito Y.：“女性 VDT 操作员中跨腕管的正中神经存在亚临床损伤。”

Murata K, Araki S, Okajima F, Nakao M, Suwa K,Matsunaga C: "Effects of occupational use of vibrating tools in the autonomic,central and peripheral nervous system." International Archives of Occupational and Environmental Health. 70. 94-100 (1998)

Murata K、Araki S、Okajima F、Nakao M、Suwa K、Matsunaga C：“职业使用振动工具对自主、中枢和周围神经系统的影响。”

Murata K, Araki S, Okajima F, Saito Y: "Subclinical impairment in the median nerve across the carpal tunnel among female VDT operators." International Archives of Occupational and Environmental Health. 68. 75-79 (1996)

Murata K、Araki S、Okajima F、Saito Y：“女性 VDT 操作员中跨腕管的正中神经存在亚临床损伤。”