高频超声评价正常成人及2型糖尿病患者下肢周围神经改变

发布时间：2018-04-28 18:53

本文选题：超声检查 + 股神经　；参考：《大连医科大学》2014年硕士论文

【摘要】：第一部高频超声评价正常成人下肢周围神经目的：探讨应用高频超声检测正常成人股神经和隐神经的方法和超声声像图表现。方法：应用高频超声探头检测42例正常志愿者双下肢股神经和隐神经，观察正常神经的声像图表现，测量宽径、厚径及横截面积（CSA）等参数，并分析其与年龄、身高、体重的相关性。结果：高频超声可清晰显示股神经的主干和隐神经的大腿主干部分。左侧与右侧的股神经与隐神经的宽径、厚径及横截面积（CSA）比较均无统计学意义（P均0.05）；股神经和隐神经的宽径、厚径及横截面积（CSA）与年龄均无相关关系（P均0.05）；股神经与隐神经的宽径、厚径及横截面积（CSA）与身高、体重呈正相关关系（P均0.05）。结论：高频超声可清晰显示股神经和隐神经的主干，对超声引导下神经阻滞定位有重要的临床意义。第二部高频超声评价2型糖尿病患者下肢周围神经改变目的：探讨应用高频超声评价2型糖尿病（T2DM）患者下肢周围神经的异常改变。方法：将81例T2DM患者分为无糖尿病周围神经病变（DPN）组（B组，共40例)；合并糖尿病周围神经病变（DPN）组（C组，共41例）；另选取42例健康志愿者为对照组（A组，共42例）。观察三组股神经和隐神经的内部回声以及连续性，测量并比较三组神经的宽径、厚径及横截面积（CSA）。结果：A组股神经和隐神经声像图横切面呈略高回声，内呈网格状，纵切面内部呈条状低回声及平行线样排列的条状略高回声； B组二者内部回声较A组略减低，内部网格状结构较模糊，纵切面条状回声欠清晰；C组内部回声较B组明显减低，内部网格状结构显示不清，纵切面条状回声结构模糊。B、C各组股神经和隐神经的宽径、厚径及横截面积（CSA）均较A组增大（P均0.05）；C组股神经和隐神经的厚径及横截面积（CSA）均较B组增大（P均0.05）。结论：高频超声可清楚显示T2DM以及合并糖尿病周围神经病变（DPN）患者股神经和隐神经主干内部回声及各径线的异常改变，为临床诊断提供客观依据，具有重要的临床意义。
[Abstract]:Evaluation of peripheral nerve of lower extremity in normal adults by high frequency ultrasound Objective: to study the method of detecting femoral nerve and saphenous nerve in normal adults by high frequency ultrasound. Methods: the femoral and saphenous nerves of the lower extremities of 42 normal volunteers were detected by high frequency ultrasound probe. The sonographic manifestations of the normal nerves were observed, and the parameters such as wide diameter, thick diameter and cross sectional area were measured, and their correlation with age and height were analyzed. The correlation of weight. Results: the trunk of femoral nerve and the trunk of thigh of saphenous nerve could be clearly displayed by high frequency ultrasound. The width, thickness and cross-sectional area of femoral nerve and saphenous nerve in left and right were not significantly different (P > 0.05), the width of femoral nerve and saphenous nerve, the width of femoral nerve and saphenous nerve, and the width of femoral nerve and saphenous nerve. There was no correlation between thick diameter and cross sectional area (CSAs) and age (P < 0.05), while the wide diameter, thick diameter and cross-sectional area of femoral nerve and saphenous nerve were positively correlated with height and weight (P < 0.05). Conclusion: high frequency ultrasound can clearly display the trunk of femoral nerve and saphenous nerve, which has important clinical significance for localization of nerve block under ultrasound guidance. Evaluation of peripheral nerve changes in patients with type 2 diabetes mellitus by high-frequency ultrasound in the second part Objective: to evaluate the abnormal changes of peripheral nerve in patients with type 2 diabetes mellitus (T2DM) by high frequency ultrasound. Methods: 81 patients with T2DM were divided into two groups: group B (n = 40) without diabetic peripheral neuropathy, group C (n = 41) with diabetic peripheral neuropathy, and group A (n = 42) as control group. The internal echo and continuity of femoral nerve and saphenous nerve were observed and the width, thickness and cross-sectional area of the nerve were measured and compared among the three groups. Results the sonograms of femoral nerve and saphenous nerve in group A were slightly hyperechoic, mesh-shaped inside, and hyperechoic in longitudinal plane, and in group B the internal echo was slightly lower than that in group A. The internal reticular structure was fuzzy, the internal echo in group C was significantly lower than that in group B, the internal reticular structure was unclear, and the width of femoral nerve and saphenous nerve in group C was blurred. The thicker diameter and cross sectional area of the femoral nerve and saphenous nerve in group C were larger than those in group A (P < 0.05). Conclusion: high frequency ultrasound can clearly display the internal echo and abnormal changes of the main trunk of femoral nerve and saphenous nerve in patients with T2DM and diabetic peripheral neuropathy. It provides an objective basis for clinical diagnosis and has important clinical significance.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R587.2;R445.1

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