Investigation of risk management and validity about clinical tests in the field of neurological medicine

1991至2005年间，共有3291名患者入院。入院记录证实患者接受了脑脊液检查824例(25%)，肌电检查306例(9.3%)，肌肉活检19例(1.9%)，神经活检19例(0.6%)。1)脑脊液检查：感染组病原体检查有效率为28.8%，常规检查或病原体检查有效率为81.8%。比较病毒和细菌等(细菌、结核病、真菌、梅毒等)结果表明，脑脊液检查对细菌等比对病毒更有用(100%对76.2%)，单用病原体检查对细菌等也比对病毒更有用(50%对19%)。在免疫性和炎症性疾病组中，53.5%的病例一般检测或特殊检测有效。此外，与其他免疫性和炎症性疾病相比，特殊检测对多发性硬化症更有用(43.8%对7-16%)。2)需要…更多的LE-EMG：这种检查对67.1%的病例有用，特别是对肌肉疾病的68.3%和其他疾病的66.7%，对运动神经元病特别有用(92.3%)。3)肌肉活检：这种检查对59.7%的病例有用，对炎症性肌肉疾病比对其他肌肉疾病更有用(89.5%对48.6%)。4)神经活检：这种检查对66.7%的病例有用，而且倾向于对炎性神经病有用。检查并发症及GT；1)脑脊液检查：头痛占20.1%，以肌肉疾病(44.4%)、运动神经元病(33.3%)、神经病变(28.3%)多见，其他疾病发生率多为10-20%。其他并发症包括背痛7例。2)针状肌电图：检查时除疼痛和不适外，无明显并发症。3)肌肉活检：3例(5.1%)创面愈合不良，但无后遗症。4)神经活检：并发症3例(16.7%)，其中2例创面愈合不良，1例创周麻木。较少

A total of 3291 patients were admitted between 1991 and 2005. Admission records confirmed that these patients underwent the following examinations : CSF examination, n=824 (25%) ; needle EMG, n=306 (9.3%) ; muscle biopsy, n=64 (1.9%) ; and nerve biopsy, n=19 (0.6%).<Usefulness of examinations>1)CSF examination : In the infection group, pathogen tests were useful in 28.8% of cases, and either general tests or pathogen tests was useful in 81.8% of cases. Comparison between viruses and bacteria, etc. (bacteria, tuberculosis, fungi, syphilis, etc.) showed that CSF examination was more useful for bacteria, etc. than for viruses (100% vs. 76.2%), and pathogen tests alone were also more useful for bacteria, etc. than for viruses (50% vs. 19%). In the immunological and inflammatory disease group, either general tests or specific tests was useful in 53.5% of cases. In addition, specific tests were more useful for MS than for other immunological and inflammatory diseases (43.8% vs. 7-16%).2)Need … More le EMG : This examination was useful in 67.1% of cases, specifically in 68.3% of cases of muscle disease and 66.7% of cases of other diseases, and was particularly useful for motor neuron disease (92.3%).3)Muscle biopsy : This examination was useful in 59.7% of cases, and was more useful for inflammatory muscle disease than for other muscle diseases (89.5% vs. 48.6%).4)Nerve biopsy : This examination was useful in 66.7% of cases, and tended to be useful for inflammatory neuropathy.<Complications of examinations>1)CSF examination : Headache was reported in 20.1% of cases, and was more frequently reported in cases of muscle disease (44.4%), motor neuron disease (33.3%), and neuropathy (28.3%), with an occurrence of 10-20% in most other diseases. Other complications comprised 7 cases of back pain.2)Needle EMG : No clear complications were reported other than pain and discomfort during examination.3)Muscle biopsy : Although poor wound healing was observed in 3 cases (5.1 %), no sequelae were reported.4)Nerve biopsy : Complications were observed in 3 cases (16.7%), including 2 cases of poor wound healing and 1 case of numbness around the wound. Less