会阴下降综合征会阴神经病变的复杂神经电生理算法

O. Fomenko, A. A. Mudrov, S. V. Belousova, M. A. Nekrasov, S. Achkasov
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摘要

患者和方法:这项前瞻性队列研究纳入了 127 名会阴下降综合征患者(85 名(66.9%)--女性),年龄为 49.9 ± 14.4 岁。所有患者均患有直肠源性便秘、肛门失禁和/或慢性神经源性骨盆疼痛。所有患者均按照最初的复杂阴茎神经末梢运动潜伏期(PNTML)方法--用于检测盆底肌肉神经支配障碍的神经生理学方案--进行了神经生理学检查。结果:85 名患者(66.9%)(50 名女性和 35 名男性)中至少有一侧的阴茎神经 M 反应潜伏期增加。采用新的复杂神经电生理诊断方案后,29.9%的患者可以发现阴部神经病变的迹象。结论:采用新的复杂神经生理学诊断算法后,有 85 例(66.9%)患者可以确定阿尔科克管和远端沿传出通路的神经支配发生了紊乱,85 例(66.9%)患者可以确定阿尔科克管和远端沿传出通路的神经支配发生了紊乱,85 例(66.9%)患者可以确定阿尔科克管和远端沿传出通路的神经支配发生了紊乱。9%),沿着阿尔科克管近端传出通路--23 例(18.1%);15 例(11.8%)同时出现传出和传入障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Complex neurophysiological algorithm for pudendal nerve neuropathy for descending perineum syndrome
Aim: to improve diagnostics for descending perineum syndrome.Patients and Methods: the prospective cohort study included 127 patients (85 (66.9%) — females), aged 49.9 ± 14.4 years with descending perineum syndrome. All patients had proctogenic constipation, anal incontinence and/or chronic neurogenic pelvic pain. All patients underwent a neurophysiological examination according to the original complex pudendal nerve terminal motor latency (PNTML) method — neurophysiological protocol for detection of the pelvic floor muscles innervation disorders.Results: the latency of the M-response of the pudendal nerve increased on at least one side in 85 (66.9%) patients (50 women and 35 men). The use of a new complex neurophysiological diagnostic protocol made it possible to identify signs of pudendal neuropathy in 29.9% of patients. The incidence of neuropathy in patients with clinically significant perineal prolapse syndrome was 96.5% in females and 97.6% in males.Conclusion: the new complex neurophysiological diagnostic algorithm made it possible to identify disorders of innervation along the efferent pathway in the Alcock’s canal and distally in 85 (66.9%) cases, along the efferent pathway proximal to the Alcock’s canal — in 23 (18.1%); a combination of efferent and afferent disturbances occurred in 15 (11.8%).
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