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

1991年至2005年间，共有3291名患者入院。入院记录证实这些患者接受了以下检查：脑脊液检查，n=824 (25%)；针刺肌电图，306例（9.3%）；肌肉活检，n=64 (1.9%)；神经活检，n=19（0.6%）。<检查的有效性>1)脑脊液检查：在感染组中，28.8%的病例病原体检查有用，81.8%的病例一般检查或病原体检查有用。病毒与细菌等（细菌、结核、真菌、梅毒等）比较，脑脊液检查对细菌等的检出率高于病毒（100%对76.2%），单独进行病原体检查对细菌等的检出率高于病毒（50%对19%）。在免疫性和炎症性疾病组中，53.5%的病例中，常规检查或特异性检查都是有用的。此外，特异性检测对MS比其他免疫和炎症性疾病更有用（43.8%比7-16%）。2)需要更多的肌电图：该检查对67.1%的病例有用，特别是对68.3%的肌肉疾病和66.7%的其他疾病，对运动神经元疾病特别有用（92.3%）。3)肌肉活检：该检查在59.7%的病例中是有用的，对炎症性肌肉疾病比其他肌肉疾病更有用（89.5%比48.6%）。4)神经活检：该检查在66.7%的病例中有用，并倾向于炎性神经病变。<检查并发症(1)脑脊液检查：20.1%的病例报告头痛，以肌肉疾病（44.4%）、运动神经元疾病（33.3%）和神经病变（28.3%）多见，其他疾病发生率为10-20%。其他并发症包括背部疼痛7例。2)针刺肌电图：除检查时疼痛不适外，未见明显并发症。3)肌肉活检：3例（5.1%）创面愈合不良，无后遗症。4)神经活检：3例（16.7%）出现并发症，其中2例创面愈合不良，1例创面周围麻木。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