Karpal tünel sendromu tanısında dijital dallarda median sinir duyu iletim testlerinin duyarlılığı
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Karabük Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Karpal tünel sendromunun erken tanısında elektrofizyolojik testlerden duyu ileti çalışmaları önemli yer tutmakta ve duyusal sinir liflerinin motor liflerden daha erken dönemde etkilendiği bilinmektedir. Bu çalışmanın amacı KTS tanısında parmak ve avuç-bilek segmentleri duyu iletim testlerinin duyarlılığını incelemek ve bu testler arasındaki ilişkiyi göstermektir. Kesitsel olan bu çalışmada Karabük Eğitim Araştırma Hastanesi Fiziksel Tıp ve Rehabilitasyon Kliniği Elektrofizyoloji Laboratuvarına 01.01.2020-01.01.2022 tarihleri arasında KTS ön tanısı ile yönlendirilen ve çalışmaya alınma kriterlerini taşıyan gönüllü katılımcılar elektrofizyolojik olarak incelenmiştir. Tüm katılımcılara bilateral üst ekstremite median sinir motor ve duyu ileti çalışması ile birlikte tek taraflı ulnar sinir duyu ve motor ileti çalışması yapılmıştır. Median sinir duyu ileti çalışmasında standart çalışmaya ek olarak avuç içi-bilek, birinci, ikinci ve üçüncü parmak-bilek duyu ileti çalışması yapılmıştır. İstatistiksel analiz için SPSS 25 versiyonu kullanılmıştır. Anlamlılık için p<0.05 değeri kabul edilmiştir. Çalışmamızda 175'i kadın 42'si erkek olmak üzere toplam 217 adet elektrofizyolojik olarak KTS tanısı konulan el incelenmiştir. Median sinirin duyu dallarının duyu ileti testlerinde avuç içi-bilek segmenti çalışması %98.62 oran ile en duyarlı olarak saptanırken, parmaklar arasında duyarlılık oranları sırasıyla 1.parmak için %96.31, 3.parmak için %94.47 ve 2.parmak için %92.63 olarak belirlendi. Katılımcıların kombine duyu ileti çalışmalarında sırasıyla duyarlılık oranları avuç içi-bilek ve 1.parmak-bilek segmenti için %100, avuç içi-bilek ve 3.parmak segmenti için %99.6 ve avuç içi-bilek ve 2.parmak segmenti %99.1 olarak saptanmıştır. Sonuç olarak bu çalışma ile duyu ileti çalışmalarında en duyarlı segment avuç içi-bilek segmenti, parmaklar arasında ise 1.parmak olarak saptanmıştır. Özellikle erken dönemde KTS tanısını atlamamak için rutin parmak duyu ileti çalışmalarına avuç içi-bilek segmentinin de eklenmesi önerilmektedir. Anahtar Kelimeler: duyu ileti testleri, duyarlılık, median sinir, dijital dallar
Sensory conduction studies, one of the electrophysiological tests, have an important role in the early diagnosis of carpal tunnel syndrome and it is known that sensory nerve fibers are affected earlier than motor fibers. The aim of this study is to examine the sensitivity of finger and palm-wrist segments sensory conduction tests in the diagnosis of CTS and to show the relationship between these tests. In this cross-sectional study, volunteer participants who were referred to Karabük Training and Research Hospital, Physical Medicine and Rehabilitation Clinic Electrophysiology Laboratory between 01.01.2020-01.01.2022 with a preliminary diagnosis of CTS and meeting the inclusion criteria were electrophysiologically examined. Bilateral upper extremity median nerve motor and sensory conduction study and unilateral ulnar nerve sensory and motor conduction study were performed on all participants. In the median nerve sensory conduction study, in addition to the standard study, sensory conduction studies from the palm, first finger, second and third finger were performed. SPSS 25 version was used for statistical analysis. A value of p<0.05 was accepted for significance. In our study, a total of 217 (175 female, 42 male) hands diagnosed with CTS electrophysiologically were examined. In the sensory conduction tests of the sensory branches of the median nerve, the palm-wrist segment study was found to be the most sensitive with a rate of 98.62%, while the sensitivity rates between the fingers were 96.31% in the 1st finger, 94.47% in the 3rd finger, and 92,63% in the 2nd finger. In the combined sensory conduction studies of the participants, the sensitivity rates were 100% for the palm-wrist and 1st finger-wrist segment, 99.6% for the palm-wrist and 3rd finger segments, and 99.1% for the palm-wrist and 2nd finger segments. As a result, in this study, the most sensitive segment in sensory conduction tests was the palm-wrist segment, and the 1st finger between the fingers. It is recommended to include the palm-wrist segment in routine finger sensory conduction studies, especially in order to diagnose CTS in the early period. Keywords: nerve conduction tests, sensitivity, median nerve, digital branches
Sensory conduction studies, one of the electrophysiological tests, have an important role in the early diagnosis of carpal tunnel syndrome and it is known that sensory nerve fibers are affected earlier than motor fibers. The aim of this study is to examine the sensitivity of finger and palm-wrist segments sensory conduction tests in the diagnosis of CTS and to show the relationship between these tests. In this cross-sectional study, volunteer participants who were referred to Karabük Training and Research Hospital, Physical Medicine and Rehabilitation Clinic Electrophysiology Laboratory between 01.01.2020-01.01.2022 with a preliminary diagnosis of CTS and meeting the inclusion criteria were electrophysiologically examined. Bilateral upper extremity median nerve motor and sensory conduction study and unilateral ulnar nerve sensory and motor conduction study were performed on all participants. In the median nerve sensory conduction study, in addition to the standard study, sensory conduction studies from the palm, first finger, second and third finger were performed. SPSS 25 version was used for statistical analysis. A value of p<0.05 was accepted for significance. In our study, a total of 217 (175 female, 42 male) hands diagnosed with CTS electrophysiologically were examined. In the sensory conduction tests of the sensory branches of the median nerve, the palm-wrist segment study was found to be the most sensitive with a rate of 98.62%, while the sensitivity rates between the fingers were 96.31% in the 1st finger, 94.47% in the 3rd finger, and 92,63% in the 2nd finger. In the combined sensory conduction studies of the participants, the sensitivity rates were 100% for the palm-wrist and 1st finger-wrist segment, 99.6% for the palm-wrist and 3rd finger segments, and 99.1% for the palm-wrist and 2nd finger segments. As a result, in this study, the most sensitive segment in sensory conduction tests was the palm-wrist segment, and the 1st finger between the fingers. It is recommended to include the palm-wrist segment in routine finger sensory conduction studies, especially in order to diagnose CTS in the early period. Keywords: nerve conduction tests, sensitivity, median nerve, digital branches
Açıklama
Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Ana Bilim Dalı
Anahtar Kelimeler
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation
