| Objective: Discussing the unique adjuvant treatment of intraoperative strongelectrical stimulation on carpal tunnel syndrome; seeking the index to reflect theimportant significance of neural electrophysiological detection in the diagnosis andtreatment of carpal tunnel syndrome.Methods:20adult patients with carpal tunnel syndrome were givenpreoperative electromyography (EMG)(after plexus nerve block (BPNP)),intraoperative nerve electrophysiology detection between incision of carpal tunnelligament and median nerve relaxation, nerve electrophysiology detection after mediannerve relaxation, and nerve electrophysiology detection after strong electricalstimulation. The patients were reviewed by nerve electrophysiology detection at1month after operation. Observing the dynamic changes of incubation period andamplitude of median nerve-abductor pollicis brevis(MN-APB for short) compoundmuscle action potential(CMAP), and recording the related data in detail, the data wasanalyzed statistically to draw corresponding meaningful results.Results: In this clinical trial:1. The incubation period of MN-APB CMAP:The average incubation period preoperative electromyography was (5.69±1.47) ms.The average incubation period intraoperative incision of carpal tunnel ligament was(4.89±1.10) ms. The average incubation period median nerve relaxation was(4.68±0.99) ms. The average incubation period strong electrical stimulation was(3.93±0.57) ms. The average incubation period1month after operation was(3.81±0.53) ms. The average incubation period after strong electrical stimulation was(3.93±0.57) ms, which was improved by28.8%.2. The amplitude of MN-APBCMAP: The average amplitude median nerve relaxation was (4.77±1.41) ms. Theaverage amplitude strong electrical stimulation was (5.70±1.82) ms. The averageamplitude1month after operation was (5.88±1.88) ms.. The average amplitude afterstrong electrical stimulation was (5.70±1.82) mv, which was improved by56.6%,compared with preoperative (3.71±1.55) mv.3. The patients were reviewed by nerveelectrophysiology detection at1month after operation. And the clinical curativeeffects were evaluated according to the upper extremity functional evaluation standardset up by hand surgery branch of Chinese Medical Association. The results showedthat12cases were excellent,5cases were good,2cases were qualified and1case wasunqualified, with fitness rate of85.0%. Conclusion: Giving direct intraoperative strong electrical stimulation to themedian nerve stem in open surgery of carpal tunnel syndrome can increase theamplitude and reduce the incubation of MN-APB CMAP, which has a uniqueauxiliary therapeutic effect. And amplitude can better reflect the auxiliary therapeuticeffect of intraoperative strong electrical stimulation than the incubation.
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