Kev Ntsuas Electromyography (EMG): Nws Qhia Dab Tsi, Nws Ua Tsis Tau Dab Tsi, thiab Nws Ua Li Cas

Tus yuam sij takeaways

• EMG ntsuas kev ua haujlwm, tsis yog qhov anatomynws tsis tuaj yeem pom ib lub disc, ib lub qog lossis pob txha, uas yog qhov MRI lossis ultrasound ua.
• EMG feem ntau yog ua ke nrog NCS: ob qhov kev xeem teb cov lus nug sib txawv thiab feem ntau tau tshaj tawm ua ke ua ib txoj kev tshawb fawb.
• Ib txoj kev tshawb fawb ib txwm tsis suav nrog kab mob: cov hlab ntsha me me, kev raug mob ntawm cov hlab ntsha thaum ntxov lossis me me, thiab ntau yam mob ntawm lub paj hlwb hauv nruab nrab tuaj yeem muab EMG thiab NCS ib txwm muaj.
• Kev tsis xis nyob yuav tshwm sim tab sis luv luv xwb: koob txhaj tshuaj mob; cov hluav taws xob ntawm NCS zoo li cov kais ntse.
• Qhia rau pab neeg txog cov tshuaj uas ua rau cov ntshav nyias, cov tshuaj pacemakers lossis cov tshuaj stimulators uas tau cog rau hauv lawv lub cev. ua ntej qhov kev kuaj mob, yam tsis tas yuav tsum tsis txhob noj tshuaj uas koj tus kheej tau sau tseg.

Ib nrais muag

Kuj hu ua

• Kev kuaj EMG, kev kuaj EMG NCV, EMG-NCS
• Kev kuaj NCV (kev kawm txog qhov ceev ntawm cov hlab ntsha), feem ntau yog yam uas cov neeg mob hauv Is Nrias teb tau hais rau lawv tias lawv muaj
• "Kev kuaj mob ntawm cov hlab ntsha", "kev kawm txog cov hlab ntsha", "kev kuaj mob ntawm cov leeg nqaij" hauv kev sib tham txhua hnub
• Kev siv koob electromyography; kev tshawb nrhiav electrodiagnostic (EDX)

Kev kuaj EMG yog dab tsi

Kev siv tshuab hluav taws xob ntawm lub cev (electromyography) sau cov teeb liab me me uas cov leeg nqaij tsim tawm. Ib lub koob electrode nyias nyias, zoo ib yam li koob acupuncture, raug muab tso rau hauv cov leeg nqaij uas tau xaiv. Tus kws kho mob saib cov leeg nqaij thaum so, thaum lub zog maj mam thiab thaum lub zog muaj zog dua, mloog thiab saib cov qauv waveform.

Kev tshawb nrhiav txog kev coj hluav taws xob ntawm cov hlab ntsha yog ib feem sib cais tab sis txuas nrog tib qho kev teem sijhawm. Cov hluav taws xob ntawm daim tawv nqaij xa cov hluav taws xob luv luv raws cov hlab ntsha, thiab cov lus teb raug kaw ntxiv raws cov hlab ntsha lossis hla cov leeg. Qhov no qhia tau tias cov hlab ntsha khiav ceev npaum li cas thiab muaj zog npaum li cas.

Lub koob EMG feem ntau qhia txog lub cev thiab cov leeg nqaij. Kev tshawb fawb no tsis kuaj txhua cov leeg nqaij lossis cov hlab ntsha hauv lub cev, tus kws kho mob xaiv cov twg los kuaj raws li koj cov tsos mob thiab kev kuaj mob, thiab tej zaum yuav ncua kev tshawb fawb thaum cov ntaub ntawv pom. Qhov no yog vim li cas EMG thiaj li zoo tshaj plaws xav txog kev ntsuam xyuas kev kho mob uas tau coj los ntawm tus kws kho mob es tsis yog ib pawg neeg uas tsis tau teem tseg.

Vim li cas thiaj ua qhov kev kuaj EMG

• Yuav cais cov hlab ntsha los ntawm cov leeg: qhov tsis muaj zog yuav los ntawm cov hlab ntsha, cov hauv paus hlab ntsha, cov hlab ntsha ntawm lub paj hlwb lossis cov leeg nqaij, thiab cov qauv EMG pab cais cov no.
• Txhawm rau nrhiav qhov chaw raug mob ntawm cov hlab ntshapiv txwv li, cov hlab ntsha nruab nrab ntawm lub dab teg hauv cov kab mob carpal tunnel syndrome, lossis cov hlab ntsha ulnar ntawm lub luj tshib.
• Txhawm rau ntsuam xyuas qhov xav tias muaj radiculopathy: kev koom tes ntawm cov hauv paus hlab ntsha los ntawm qhov teeb meem ntawm lub caj dab lossis lub duav, tshwj xeeb tshaj yog thaum cov duab pom thiab cov tsos mob tsis sib xws.
• Yuav ua li cas los txiav txim siab qhov mob ntawm peripheral neuropathy: seb nws yog feem ntau axonal lossis demyelinating, symmetric lossis patchy, sensory lossis motor.
• Txhawm rau tshawb nrhiav seb puas muaj kab mob motor neuron lossis myopathy, ua ib feem ntawm kev ntsuam xyuas dav dua.
• Ua raws li kev rov qab los tom qab raug mob hlab ntsha lossis phais hlab ntsha, vim tias cov kev hloov pauv ntawm lub paj hlwb rov qab tshwm sim ntawm EMG dhau ob peb lub lis piam mus rau ntau lub hlis.

Leej twg yuav tsum tau txais qhov kev xeem no

Tus kws kho mob yuav tsum tau ua EMG-NCS tom qab kev ntsuam xyuas kev kho mob, tsis yog tus neeg mob xaiv. Feem ntau nws yog xav txog rau cov neeg uas muaj:

• Tsis tu ncua loog, tingling lossis kub hnyiab hauv tes lossis taw
• Tsis muaj zog, qaug zog lossis nquag dawm taw, ko taw poob lossis tes tsis khov kho
• Kev mob tes thaum hmo ntuj lossis mob uas qhia txog carpal tunnel syndrome
• Qhov mob kis mus rau ib sab caj npab lossis ceg qhov twg qib ntawm cov hlab ntsha tsis meej
• Cov leeg nqaij ntswj los yog mob plab nrog lub zog tsis muaj zog
• Xav tias muaj tus kab mob ntshav qab zib lossis lwm yam kab mob metabolic neuropathy uas yuav tsum tau piav qhia
• Paub txog kev raug mob ntawm cov hlab ntsha, qhov twg qhov hnyav thiab kev rov zoo yuav tsum tau soj ntsuam

Feem ntau EMG tsis daws qhov mob uas tsis muaj kev xav lossis kev txav mus los tsis zoo, lossis qaug zog xwb. Cov txiaj ntsig sib txawv nyob ntawm tus neeg mob tus mob.

Tej yam uas EMG kuaj tsis tuaj yeem ntes tau lossis tsis suav nrog

• Tsis muaj duab ntawm lub cev. EMG tsis tuaj yeem qhia tau tias lub disc prolapse, qhov nqaim ntawm tus txha nqaj qaum, qog, ganglion lossis cov leeg nqaij tawg. Xav tau MRI, CT lossis ultrasound rau qhov kev teeb tsa.
• Feem ntau cov kab mob me me uas ua rau mob neuropathy tsis pom. Kev kuaj mob NCS ib txwm yuav soj ntsuam cov leeg nqaij loj uas muaj myelinated. Kev kub hnyiab ntawm ko taw nrog kev tshawb fawb ib txwm muaj tej zaum yuav qhia tau tias muaj cov leeg nqaij me me koom nrog, uas xav tau lwm yam kev kuaj.
• Qhov mob ntsuas tsis tau. Tsis muaj qhov kev tshawb pom EMG uas lees paub lossis ntsuas qhov mob.
• Cov qhov txhab uas pib mob los yog me me xwb tej zaum yuav yog ib qho zoo li qub. Tom qab raug mob hlab ntsha hnyav, kev hloov pauv ntawm denervation ntawm koob EMG feem ntau siv sijhawm ob peb lub lis piam kom tshwm sim, yog li kev tshawb fawb thaum ntxov heev tuaj yeem tsis quav ntsej qhov hnyav.
• Tsis muaj kev ntsuam xyuas kab mob ntawm lub paj hlwb. EMG tsis kuaj pom tus kab mob stroke, multiple sclerosis, Parkinson's disease thiab spinal cord disease. Cov lus thov qub hais tias EMG "saib xyuas Parkinson's disease lossis multiple sclerosis" yog qhov tsis raug thiab tau raug tshem tawm lawm.
• Tsis yog txhua cov leeg nqaij lossis cov hlab ntsha raug kuaj, yog li ntawd qhov mob sab nraum thaj chaw kuaj mob tuaj yeem tsis pom.
• Tus qauv EMG tsis yog qhov kev kuaj mob rau cov neeg mob myasthenia gravis uas xav tias muaj nws tus kheej.siv kev txhawb nqa cov hlab ntsha rov ua dua lossis kev tshawb fawb ib leeg ntxiv rau kev kuaj cov tshuaj tiv thaiv kab mob.

Ib txoj kev tshawb fawb uas tau tshaj tawm tias zoo li qub txhais tau tias tsis muaj qhov txawv txav tau pom hauv cov hlab ntsha thiab cov leeg nqaij uas tau kuaj, los ntawm cov txheej txheem siv, rau hnub ntawd. Qhov ntawd tsis zoo ib yam li kev tshem tawm kab mob. Yog tias koj cov tsos mob tseem muaj lossis hnyav zuj zus txawm tias muaj daim ntawv qhia zoo li qub, rov qab mus rau tus kws kho mob uas tau thov kom kuaj.

Kev ntsuam xyuas sib txuas tab sis sib txawv

Qhov kev kuaj twg yuav ua ntej nyob ntawm seb qhov teeb meem kev kho mob yog dab tsi. Rau qhov mob tes loog thaum hmo ntuj uas qhia txog mob carpal tunnel syndrome, EMG-NCS feem ntau yog qhov kev kuaj thawj zaug uas muaj ntaub ntawv ntau dua. Rau qhov mob nraub qaum hnyav tam sim ntawd nrog rau ceg tsis muaj zog thiab lub zais zis tsis ua haujlwm, MRI ceev ceev yuav tsum muaj qhov tseem ceeb. Rau qhov xav tias muaj mob myopathy, kev kuaj ntshav thiab MRI yuav ua ntej EMG. Tsis muaj ib qho kev kuaj twg zoo dua thoob plaws txhua qhov kev nthuav qhia.

Yuav npaj li cas rau kev kuaj EMG

Cov lus qhia txog kev npaj yog raws li chav kawm. Yog tias cov lus qhia sau ntawm koj lub chaw ua haujlwm txawv ntawm cov lus qhia dav dav, cov lus qhia ntawm koj lub chaw ua haujlwm yuav tseem ceeb dua.

• Kev tu tawv nqaij: ntxuav cov ceg thiab tsis txhob siv tshuaj pleev ib ce, roj, hmoov lossis tshuaj pleev kom noo noo rau hnub ntawd, vim tias cov no cuam tshuam rau kev sib cuag ntawm lub electrode.
• Khaub ncaws: cov khaub ncaws xoob uas tso cai rau kev nkag mus rau caj npab, ceg lossis thaj chaw uas muaj kev txhawj xeeb.
• Nqa koj cov ntaub ntawv tuaj: kev tshawb fawb txog cov hlab ntsha yav dhau los, kev thaij duab, thiab daim ntawv teev cov tshuaj tam sim no, suav nrog AYUSH thiab cov khoom uas yuav tau ntawm daim ntawv muag tshuaj.
• Qhov sov tseem ceeb: Cov ceg txias ua rau cov hlab ntsha qeeb thiab ua rau cov txiaj ntsig tsis zoo. Khaws tes thiab taw kom sov thaum nkag mus; lub tshuab yuav ua rau ceg sov ua ntej kaw.
• Cov tshuaj kho mob: qhia rau pab neeg txog cov tshuaj uas ua rau cov ntshav nyias, cov tshuaj tiv thaiv cov ntshav txhaws, cov tshuaj ua kom cov leeg so, cov tshuaj pyridostigmine lossis cov tshuaj rau myasthenia gravis. Tsis txhob pib, tsum lossis hloov cov tshuaj uas tau muab rau koj tus kheej, nrog tus kws kho mob tham, uas yuav qhia koj yog tias qhov kev hloov pauv ib ntus tsim nyog.
• Kev yoo mov: feem ntau tsis tas yuav kawm li niaj zaus. Ua raws li cov lus qhia ntawm koj chav kawm.

Yog tias koj muaj lub tshuab pacemaker, ICD lossis lub tshuab implanted stimulator

Qhia rau chav tsev ua ntej teem caij. Kev tshawb nrhiav txog kev coj cov hlab ntsha muaj xws li kev siv hluav taws xob los pab thiab yuav tsum tau muaj kev ntsuam xyuas kev nyab xeeb thiab feem ntau hloov kho qhov chaw uas yuav tsum tau pab. Kev tshawb nrhiav no feem ntau tseem ua tau yog tias muaj kev ceev faj tsim nyog.

Yog koj noj tshuaj uas ua rau cov ntshav nyias los yog muaj teeb meem los ntshav

Koob txhaj tshuaj EMG muaj qhov pheej hmoo me ntsis los ntshav thiab mob nqaij. Lub tshuab no yuav txwv cov leeg nqaij uas raug kuaj, zam cov leeg nqaij tob, lossis thov kom tau cov txiaj ntsig ntshav khov tshiab. Txhua qhov kev txiav txim siab txog koj cov tshuaj anticoagulant yog nyob ntawm tus kws kho mob sau ntawv.

Yog koj muaj mob ntshav qab zib uas tab tom kho mob kom txo cov piam thaj (glycolysis)

Yog koj lub chaw kho mob hais kom koj yoo mov, qhia meej seb yuav siv cov tshuaj insulin lossis cov tshuaj ntsiav li cas, thiab nqa ib yam khoom uas ua haujlwm sai sai. Tsis txhob hla lossis noj ob npaug ntawm cov tshuaj yam tsis tau tus kws kho mob qhia.

Yog tias koj muaj lymphoedema lossis ib ceg nrog lub fistula

Qhia txog qhov fistula ntxuav dialysis, kev phais mob qog ntshav axillary yav dhau los lossis lymphoedema. Feem ntau pab neeg yuav tsis txhob siv koob lossis siv zog rau ceg ntawd.

Cev xeeb tub

EMG thiab NCS tsis siv hluav taws xob ionizing thiab tsis muaj contrast. Qhia rau pab neeg kom lawv paub qhov chaw thiab qhov dav ntawm kev tshawb fawb kom lawv xis nyob.

Cov me nyuam

Kev tshawb fawb txog menyuam yaus raug luv dua thiab tsom mus rau qhov tseem ceeb, feem ntau yog ua los ntawm cov chav kawm uas muaj kev paub txog menyuam yaus, nrog rau niam txiv nyob ntawd. Kev siv tshuaj loog tsis tshua muaj tab sis qee zaum xav txog rau cov menyuam yaus me lossis cov menyuam yaus uas muaj kev ntxhov siab.

Kev kis kab mob ntawm daim tawv nqaij, mob qog lossis pob khaus

Cov koob txhaj tsis raug muab ntxig rau hauv daim tawv nqaij uas muaj kab mob lossis tawg. Yuav xaiv lwm cov leeg nqaij.

Muaj dab tsi tshwm sim thaum lub sijhawm kuaj EMG

• Txoj Haujlwm: koj pw saum lub rooj zaum lossis zaum, nyob ntawm thaj chaw uas koj tab tom kuaj xyuas.
• Kev coj cov hlab ntsha ua ntej, feem ntau: cov electrodes thiab gel saum npoo av raug muab tso rau, thiab muab cov hluav taws xob luv luv. Txhua lub suab zoo li lub khob lossis lub suab nrov, thiab tej zaum yuav ua rau pom kev co.
• Koob EMG: Ib lub koob electrode me me raug ntxig rau hauv ib qho leeg nqaij uas koj xaiv. Koj yuav raug hais kom so kom tag, tom qab ntawd maj mam zawm, tom qab ntawd zawm kom nruj dua. Lub koob raug hloov me ntsis rau hauv cov leeg nqaij ntau zaus.
• Muaj ntau cov leeg thiab cov hlab ntsha: tus kws kho mob yuav ntxiv cov chaw thaum daim duab loj hlob tuaj, tom qab ntawd piav qhia tias xav tau kev kuaj ntxiv.
• Tham thaum lub sijhawm xeem: qhia rau tus neeg teb xov tooj yog tias qhov tsis xis nyob ntau dhau, yog tias koj xav tias tsaus muag, lossis yog tias koj tsis tau so, kev so kom txaus yuav cuam tshuam rau qhov zoo ntawm kev kaw suab.

Cov txheej txheem siv sijhawm ntev npaum li cas

• Kev tshawb fawb ib cheeb tsam (piv txwv li ob txhais tes rau qhov xav tias muaj mob carpal tunnel syndrome): feem ntau li ntawm 20-40 feeb.
• Tus qauv EMG nrog NCS ntawm ib lossis ob ceg: feem ntau yog 30-60 feeb.
• Kev tshawb fawb dav dav (mob neuropathy dav dav, xav tias muaj kab mob motor neurone, kev kuaj plaub ceg, lossis kev txhawb nqa rov ua dua ntxiv): yuav siv sijhawm 60-90 feeb lossis ntau dua.
• Tag nrho lub sijhawm nyob rau hauv qhov chaw ntev dua li lub sijhawm sau cia, vim tias kev sau npe, kev ntsuam xyuas kev kho mob thiab kev ua kom ceg sov ntxiv rau.

Kev xyaum ua kev tshaj tawm txawv. Qee chav kawm muab kev xav ua ntej rau hnub ntawd; daim ntawv tshaj tawm raug cai yuav ua tom qab. Nug koj chav kawm thaum twg daim ntawv tshaj tawm yuav muaj thiab leej twg yuav piav qhia rau koj.

Kev Nkag Siab Txog Koj Daim Ntawv Qhia EMG

Daim ntawv qhia txog kev kuaj mob hluav taws xob yog ib daim ntawv piav qhia. Feem ntau nws muaj peb ntu: cov lus qhia txog cov nqi ntawm cov hlab ntsha, cov lus qhia luv luv txog cov ntaub ntawv ntawm koob txhaj tshuaj EMG rau txhua tus leeg, thiab cov lus xaus. Cov lus xaus yog qhov tseem ceeb tshaj plaws rau koj thiab rau koj tus kws kho mob.

Lub ntsiab lus ntawm daim ntawv qhia ib txwm muaj

Cov leeg nqaij qhia tias tsis muaj hluav taws xob thaum so, thiab qhov loj me ntawm lub cev, cov duab thiab kev sib koom ua ke ntawm lub cev thaum lub cev qaug zog. Cov nqi ntawm cov hlab ntsha nyob hauv qhov txwv ntawm lub chaw kuaj mob, uas nyob ntawm cov txheej txheem, cov khoom siv thiab qhov kub ntawm ceg uas lub cev ntawd siv. Daim ntawv qhia ib txwm txhais tau tias tsis muaj qhov txawv txav hauv qhov uas tau kuaj.

Cov lus tsis zoo uas feem ntau siv thiab lawv qhia dab tsi

• Cov peev xwm ntawm fibrillation thiab cov nthwv dej ntse zoo: ua ub ua no yam tsis tau npaj tseg thaum so, feem ntau pom tom qab cov hlab ntsha poob, tab sis kuj pom muaj nyob rau hauv qee cov kab mob leeg. Tsis yog tshwj xeeb rau ib qho kev kuaj mob.
• Cov peev xwm ntawm Fasciculation: kev ua haujlwm ntawm lub cev muaj zog tsis tu ncua. Cov kab mob benign fasciculations feem ntau tshwm sim rau cov neeg noj qab haus huv; qhov tseem ceeb nyob ntawm seb lawv puas tshwm sim nrog lwm yam kev txawv txav.
• Cov chav loj, ntev ntev uas muaj tsawg tus neeg ua haujlwm: ib qho qauv feem ntau piav qhia tias yog neurogenic, qhia txog kev poob ntawm cov hlab ntsha ntev nrog kev rov ua dua tshiab.
• Cov chav me me, luv luv nrog kev nrhiav neeg ua haujlwm thaum ntxov: ib qho qauv feem ntau piav qhia tias yog myopathic, qhia txog kab mob ntawm cov leeg nqaij.
• Qhov ceev ntawm kev sib kis qeeb lossis lub sijhawm ntev ntawm qhov deb: cov ntsiab lus ntawm demyelination lossis focal nerve compression.
• Txo qhov teb amplitude: taw qhia rau kev poob ntawm cov hlab ntsha lossis cov leeg nqaij teb, piav qhia tias yog axonal.
• Kev thaiv kev sib txuas: teeb liab poob thoob plaws ib ntu, pom nyob rau hauv focal compression thiab nyob rau hauv qee qhov immune neuropathies.

Cov no yog cov qauv, tsis yog kev kuaj mob. Cov qauv tib yam no haum rau ntau yam mob. Tsuas yog tus kws kho mob uas tau thov kev tshawb fawb, nrog koj keeb kwm thiab kev kuaj mob, thiaj li hloov tau daim ntawv qhia mus ua kev kuaj mob thiab kev npaj.

Vim li cas cov lus qhia txog kev ntsuas qib thiab qhov hnyav yuav tsum tau nyeem kom zoo zoo

Cov lus xws li "me me", "nruab nrab" lossis "loj" carpal tunnel syndrome ntawm daim ntawv qhia EMG qhia txog cov ntaub ntawv hluav taws xob, tsis yog qhov koj txhais tes ua rau koj ntxhov siab npaum li cas. Qee tus neeg uas muaj cov ntaub ntawv hluav taws xob me me muaj cov tsos mob tseem ceeb, thiab qhov rov qab kuj tshwm sim. Qhov kev ntsuas qhov hnyav sib txawv ntawm cov chaw kuaj mob thiab nyob ntawm cov txheej txheem thiab qhov kub. Tsis txhob siv qhov ntsuas ib leeg los txiav txim siab txog kev phais.

Thaum cov txiaj ntsig EMG tuaj yeem ua rau yuam kev

Cov kev tshawb pom uas zoo li tsis zoo li qub lossis phem dua li qhov tseeb

• Txias caj dab kev coj mus los qeeb thiab ua kom ntev lub sijhawm, ua raws li neuropathy lossis entrapment.
• Kev so tsis zoo lossis mob thaum lub sijhawm txhaj koob EMG tsim cov haujlwm ywj siab uas tuaj yeem nkag siab yuam kev tias yog kev ua ub ua no yam tsis tau npaj tseg.
• Kev ntxig koob tuaj yeem zoo li fibrillation yog tias tsis paub qhov txawv zoo.
• Oedema, rog dhau los yog cov ntaub so ntswg tuab tuaj yeem txo cov amplitudes uas tau kaw tseg yam tsis muaj kev poob hlab ntsha tiag tiag.
• Kev hloov pauv ntsig txog hnub nyoog: cov neeg laus feem ntau muaj kev teb tsis zoo me ntsis, tshwj xeeb tshaj yog nyob rau hauv ko taw, tsis muaj kev mob neuropathy.
• Cov kab mob benign tuaj yeem ua rau muaj kev txhawj xeeb ntawm daim ntawv tshaj tawm tab sis feem ntau tsis muaj txiaj ntsig dab tsi yog tias cais tawm.

Cov kev tshawb pom uas zoo li tsis zoo li qub lossis zoo dua li qhov tseeb

• Kev kuaj mob ntxov dhau tom qab raug mob hlab ntsha hnyav, ua ntej kev hloov pauv ntawm denervation tshwm sim, tsis hais txog qhov hnyav.
• Kev koom tes me me thiab kev koom tes ntawm tus kheej tsis raug ntes los ntawm cov txheej txheem niaj hnub.
• Cov tsos mob tsis tu ncuapiv txwv li qhov tsis hnov ​​​​​​lus zoo, tej zaum yuav tshwm sim nrog cov ntaub ntawv ib txwm thaum so.
• Cov kev txwv ntawm kev kuaj: yog tias cov leeg nqaij lossis cov hlab ntsha uas raug mob tsis tau kuaj, qhov kev tshawb fawb no yuav zoo li qub.
• Mob myopathy proximal me me tej zaum yuav muab koob txhaj tshuaj EMG ze li qub rau hauv cov leeg nqaij uas xaiv.
• Cov ceg sov heev tuaj yeem normalize borderline slowing.

Vim li no, cov ntaub ntawv kuaj mob los ntawm hluav taws xob yeej ib txwm raug ntsuas piv rau koj cov tsos mob. Qhov tsis sib xws yog ib qho laj thawj los tshuaj xyuas, tsis yog los tsis quav ntsej txog daim ntawv tshaj tawm lossis koj cov tsos mob.

Kev Pheej Hmoo thiab Kev Nyab Xeeb

Cov kev pheej hmoo sib txawv ntawm cov ntu ntawm kev tshawb fawb, yog li ntawd lawv yuav tsum tsis txhob piav qhia nrog ib daim ntawv qhia txog kev nyab xeeb.

Kev tshawb nrhiav txog kev coj ntawm cov hlab ntsha (kev txhawb nqa ntawm qhov chaw)

Qhov teeb meem tseem ceeb yog qhov tsis xis nyob los ntawm cov hluav taws xob pulses, thiab nws luv luv xwb. Tsis muaj koob txhaj rau hauv cov leeg nqaij. Daim tawv nqaij liab lossis khaus me ntsis los ntawm electrode gel lossis daim kab xev tuaj yeem tshwm sim. Cov neeg uas muaj lub plawv pacemakers, defibrillators lossis implanted stimulators xav tau kev ntsuam xyuas kev nyab xeeb thiab kev kho cov txheej txheem.

Koob EMG

Cov teebmeem uas xav tau suav nrog kev mob thaum ntxig thiab mob nqaij rau ob peb teev txog ib lossis ob hnub. Cov qhov me me yog qhov tshwm sim ntau. Kev kis kab mob ntawm qhov chaw txhaj tshuaj tsis tshua muaj, vim tias siv cov koob txhaj tshuaj uas tsis muaj kab mob ib zaug xwb. Kev los ntshav ntau rau hauv cov leeg tsis tshua muaj thiab yog qhov yuav tsum tau xav txog ntau dua nrog kev tiv thaiv kev coagulation lossis kev mob ntshav. Kev siv koob txhaj tshuaj rau cov leeg ze ntawm phab ntsa hauv siab muaj kev pheej hmoo me me ntawm pneumothorax, yog vim li cas cov leeg no tsuas yog kuaj thaum xav tau thiab los ntawm cov neeg ua haujlwm paub dhau los. Qee tus neeg xav tias tsaus muag thaum lub sijhawm kuaj; qhia rau pab pawg neeg yog tias koj muaj keeb kwm tsaus muag thaum lub sijhawm ua haujlwm.

Dab tsi tsis tshwm sim

EMG thiab NCS tsis siv hluav taws xob, tsis muaj tshuaj zas thiab tsis muaj tshuaj loog hauv kev xyaum ua niaj hnub. Qhov kev kuaj mob no tsis ua rau cov hlab ntsha lossis cov leeg puas tsuaj thiab tsis ua rau muaj tus kab mob uas tab tom tshawb nrhiav.

Cov xwm txheej tshwj xeeb

Mob ntshav qab zib

Kab mob ntshav qab zib yog ib qho ntawm cov laj thawj feem ntau ua rau muaj kab mob neuropathy hauv Is Nrias teb. EMG-NCS tuaj yeem piav qhia tus qauv thiab txheeb xyuas qhov kev cuam tshuam sib tshooj xws li carpal tunnel syndrome, uas feem ntau tshwm sim rau cov neeg uas muaj kab mob ntshav qab zib. Kev tshawb fawb txog cov kab mob fiber ntau ib txwm tsis suav nrog cov kab mob ntshav qab zib me me uas mob.

Kab mob raum ntev thiab kev ntxuav ntshav

Kab mob Uraemic neuropathy, carpal tunnel syndrome uas cuam tshuam nrog fistula, thiab ceg oedema tuaj yeem cuam tshuam rau cov kev tshawb pom. Feem ntau tsis txhob kuaj hauv ceg fistula, thiab lub sijhawm ntxuav dialysis yuav cuam tshuam rau lub sijhawm.

Cov laus

Cov kev xav ntawm ko taw yuav txo qis me ntsis thiab kev txav mus los qeeb me ntsis yog ib qho uas feem ntau tshwm sim thaum muaj hnub nyoog. Kev txhais lus yuav tsum siv cov kev cia siab uas tsim nyog rau hnub nyoog, thiab kev tso qhov chaw yuav xav tau kev txhawb nqa ntau dua rau kev nplij siab.

Cov me nyuam

Cov kev tshawb fawb luv luv thiab tsom mus rau ib qho xwb. Cov nqi siv los ua piv txwv txawv ntawm cov neeg laus, vim tias qhov ceev ntawm kev coj hluav taws xob loj hlob tuaj thaum ob peb xyoos thawj zaug ntawm lub neej.

Cev xeeb tub

Cov tsos mob ntawm qhov carpal tunnel feem ntau tshwm sim thaum cev xeeb tub thiab feem ntau zoo dua tom qab yug menyuam. EMG-NCS tsis tas siv tshuaj tua kab mob. Kev tswj hwm kom zoo feem ntau yog ua ntej, yog li kev kuaj mob siv thaum kuaj mob lossis qhov hnyav tsis meej.

Cov neeg uas noj tshuaj anticoagulants los yog cov neeg uas muaj thrombocytopenia

Qhov dav ntawm kev siv koob txhaj tshuaj yog raws li qhov koj xav tau, thiab feem ntau tsis txhob siv cov leeg nqaij tob lossis cov leeg nqaij uas muaj kev pheej hmoo siab. Kev txiav txim siab txog cov tshuaj yog los ntawm tus kws sau ntawv sau tshuaj, tsis yog los ntawm chav kuaj ib leeg xwb.

Kev kuaj EMG hauv Is Nrias teb

• Terminology: Muaj ntau tus neeg mob tau raug qhia tias lawv xav tau "kev kuaj NCV" lossis "kev kuaj hlab ntsha". Hauv kev xyaum, kev xa mus rau kev kawm EMG-NCS feem ntau yog rau kev kawm EMG, thiab feem ntau ntxiv koob EMG rau hnub ntawd nyob ntawm seb pom dab tsi. Nug seb puas yuav siv koob kom koj tsis txhob xav tsis thoob.
• Mob ntshav qab zib muaj feem xyuam rau neuropathy yog ib qho tseem ceeb ntawm kev xa mus rau lwm tus, vim yog lub nra hnyav ntawm tus kab mob ntshav qab zib hom 2 hauv Is Nrias teb.
• Kev noj haus thiab vitamin B12 tsis txaus neuropathy feem ntau pom muaj, tshwj xeeb tshaj yog nrog cov zaub mov tsis muaj nqaij thiab tom qab phais plab, thiab muaj peev xwm kho tau, yog vim li cas kev kuaj ntshav feem ntau nrog rau kev kawm electrodiagnostic.
• Kab mob neuropathy uas cuam tshuam nrog mob ruas tseem muaj feem cuam tshuam rau kev kho mob hauv qee qhov ntawm Is Nrias teb thiab tsim cov qauv tshwj xeeb ntawm cov hlab ntsha focal thickening thiab mononeuropathy multiplex. Kev kuaj mob hlab ntsha ultrasound thiab kev kuaj mob ntxiv rau kev kuaj mob electrodiagnosis ntawm no.
• Kev raug ntes los ntawm kev ua haujlwm thiab kev ntxhov siab rov ua duamob carpal tunnel thiab ulnar neuropathy, yog cov kev xa mus rau ntau tus neeg ua haujlwm siv tes, cov neeg caij ob lub log thiab cov neeg ua haujlwm hauv rooj.
• Cov kab mob neuropathy uas cuam tshuam nrog tshuaj thiab tshuaj lom: Kev kho mob ntsws, tshwj xeeb yog isoniazid uas tsis muaj pyridoxine txaus, qee cov tshuaj chemotherapy, thiab qee zaum cov tshuaj ntsuab lossis cov tshuaj ntxiv rau hauv gym uas tsis tau tswj hwm tuaj yeem pab tau. Nqa daim ntawv teev tag nrho suav nrog cov khoom AYUSH thiab cov tshuaj ntxiv.
• muaj: Cov chaw kuaj mob electrodiagnostic sib sau ua ke hauv cov nroog loj thiab cov nroog loj, thiab lub sijhawm tos sib txawv ntawm cov chaw pej xeem thiab cov chaw ntiag tug.
• Cov ntaub ntawv: Cov ntaub ntawv kaw cia txog kev kawm txog cov hlab ntsha, cov ntawv qhia thiab txhua daim ntawv digital uas koj sau tiav yog cov ntaub ntawv kev noj qab haus huv tus kheej thiab yuav tsum tau ua raws li Txoj Cai Tiv Thaiv Cov Ntaub Ntawv Tus Kheej Digital, 2023.

Tus nqi thiab kev pov hwm hauv Is Nrias teb

Cov nqi rau EMG-NCS hauv Is Nrias teb sib txawv ntau heev thiab raug hais rau ib txoj kev tshawb fawb es tsis yog ib koob. Thov kom muaj kev kwv yees ua ntej teem sijhawm, vim tias tus nqi kawg nyob ntawm seb txoj kev tshawb fawb loj npaum li cas.

• Tus naj npawb ntawm cov ceg thiab cov hlab ntsha uas tau kawmkev kawm ib txhais tes pheej yig dua li kev kawm plaub ceg.
• Seb puas ntxiv koob EMG rau kev tshawb nrhiav txog kev xa xov ntawm cov hlab ntsha, thiab muaj pes tsawg tus leeg nqaij raug kuaj.
• Cov txheej txheem ntxiv xws li kev ua kom cov hlab ntsha rov ua dua, F-waves, blink reflex lossis autonomic testing.
• Hom chaw: tsoom fwv, kev ntseeg siab, chaw kuaj mob hlwb ib leeg lossis tsev kho mob ntawm cov tuam txhab.
• Lub nroog thiab theem ntawm qhov chaw.
• Kev koom tes ntawm tus kws pab tswv yim: seb tus kws kho mob hlwb tus nqi sab laj thiab txhais lus puas yog sib cais lossis ua ke.
• Kev Khomob: Ua ib qho kev kuaj mob, EMG-NCS feem ntau tsis them rau cov neeg mob sab nraud tshwj tsis yog tias daim ntawv pov hwm suav nrog cov txiaj ntsig kho mob sab nraud lossis kev kuaj mob. Nws feem ntau tau txais nyiaj rov qab thaum ua thaum lub sijhawm nkag mus lossis ua ib feem ntawm kev ntsuam xyuas ua ntej phais uas tau pom zoo. Paub meej nrog koj tus neeg pov hwm lossis lub rooj pov hwm ntawm tsev kho mob ua ntej.

Cov lus dab neeg thiab qhov tseeb

Lus nug cov lus nug

Puas yog kev kuaj EMG mob?

Cov neeg feem coob piav qhia tias mob me ntsis thaum txhua koob txhaj tshuaj, thiab mob thaum lub sijhawm txhawb nqa cov hlab ntsha. Qhov mob tsuas kav ob peb feeb xwb, tsis yog mob thoob plaws. Qhov mob tom qab ntawd feem ntau tsis mob heev thiab ploj mus li ib lossis ob hnub. Qhia rau tus neeg teb xov tooj yog tias qhov mob nyuaj, vim tias feem ntau tuaj yeem hloov kho tau.

Kuv puas xav tau ob qho tib si EMG thiab NCS?

Feem ntau yog, vim lawv teb cov lus nug sib txawv. Kev tshawb fawb txog kev coj ua ntawm cov hlab ntsha ntsuas seb cov hlab ntsha ua li cas; koob EMG ntsuas tus cwj pwm ntawm cov leeg thiab kev rov ua kom lub hlwb rov qab zoo li qub. Qee qhov teeb meem, xws li tus kab mob carpal tunnel syndrome, feem ntau yuav teb tau los ntawm kev tshawb fawb txog kev coj ua ntawm cov hlab ntsha. Tus kws kho mob txiav txim siab rau hnub ntawd raws li cov ntaub ntawv pom.

Kuv puas tuaj yeem tso tseg kuv cov ntshav nyias ua ntej EMG?

Tsis txhob tsum lossis hloov cov tshuaj uas koj tau muab rau koj tus kheej. Qhia rau chav kuaj thiab nrog tus kws kho mob uas tau muab cov tshuaj anticoagulant tham. Ntau txoj kev tshawb fawb EMG siv koob txhaj tshuaj ua mus zoo nrog cov tshuaj anticoagulant los ntawm kev txwv cov leeg nqaij uas tau kuaj thiab zam cov qhov tob tob.

Kuv puas tsav tsheb mus tsev tom qab ntawd tau?

Kev siv EMG-NCS ib txwm tsis siv tshuaj loog, yog li feem ntau cov neeg tsav tsheb lossis mus tsev yam tsis muaj kev pab. Yog tias kuaj thaj chaw loj, yog tias koj xav tias koj tsis muaj zog thaum lub sijhawm kawm, lossis yog tias ib ceg mob, npaj lwm txoj kev thauj mus los. Ua raws li cov lus qhia tshwj xeeb uas koj lub chaw kho mob muab rau koj.

Puas yog EMG yuav hloov kuv daim MRI scan?

Tsis yog. Ob qho kev kuaj no yog ua ke. MRI qhia txog cov qauv xws li cov discs, cov hlab ntsha thiab cov leeg nqaij; EMG qhia seb cov hlab ntsha thiab cov leeg nqaij puas ua haujlwm. Thaum cov duab thaij qhia txog kev hloov pauv ntawm ntau qib ntawm tus txha caj qaum, EMG tuaj yeem pab txheeb xyuas qib twg yog lub luag haujlwm.

Vim li cas tus kws kho mob thiaj kuaj cov leeg nqaij ntau dua li kuv xav tau?

Kev kuaj mob hluav taws xob yog qhov hloov pauv tau. Yog tias cov ntaub ntawv pom thaum ntxov qhia txog qhov teeb meem dav dua lossis txawv, tus kws kho mob nthuav dav txoj kev tshawb fawb los txhais cov qauv, piv txwv li kuaj xyuas lwm ceg, lossis cov leeg nqaij uas tau txais los ntawm cov hauv paus paj hlwb sib txawv. Qhov no txhim kho qhov tseeb dua li qhia tias muaj qee yam loj heev tau pom.

Puas yog EMG kuaj tau ALS lossis mob motor neurone ntawm nws tus kheej?

Tsis muaj ib qho kev kuaj mob twg uas kuaj tau tus kab mob ntawm cov hlab ntsha hauv lub cev. Cov ntaub ntawv EMG ntawm kev puas tsuaj dav dav thiab kev rov ua dua tshiab yog ib feem ntawm cov qauv kuaj mob uas tau teeb tsa, tab sis kev kuaj mob yuav tsum tau kuaj mob hauv chaw kho mob, tsis suav nrog cov kev sim ua ke thiab feem ntau yog kev thaij duab thiab kev kuaj ntshav. Tham txog cov ntaub ntawv uas tau pom nrog tus kws kho mob hlwb ua ntej txiav txim siab.

Cov menyuam yaus puas tuaj yeem kuaj EMG tau?

Yog lawm, thiab kev tshawb fawb txog menyuam yaus raug luv dua thiab tsom mus rau. Cov nqi siv piv txwv txawv ntawm cov neeg laus vim tias kev xa xov ntawm cov hlab ntsha loj hlob thaum yau. Cov chav kawm uas muaj kev paub txog kev kho mob hlwb rau menyuam yaus feem ntau tso cai rau niam txiv nyob. Kev siv tshuaj loog tsis tshua muaj thiab tsuas yog xav txog qee qhov xwm txheej xwb.

Yog tias kuv daim ntawv qhia txog kuv tus mob zoo li qub tab sis kuv cov tsos mob tseem muaj?

Rov qab mus rau tus kws kho mob uas tau thov kom ua qhov kev tshawb fawb no. Cov txiaj ntsig zoo li qub yuav ua rau muaj qhov tshwm sim tsawg dua tab sis tsis suav nrog cov kab mob me me ntawm cov hlab ntsha, kev raug mob ntawm cov hlab ntsha thaum ntxov, cov laj thawj tseem ceeb lossis cov teeb meem ntawm cov leeg thiab pob txha. Kev ntsuam xyuas ntxiv yuav suav nrog kev kuaj ntshav, kev thaij duab, kev kuaj dua tom qab lub sijhawm so, lossis kev xa mus rau kws kho mob tshwj xeeb.

Qhov chaw

• Lub Koom Haum Amelikas ntawm Neuromuscular thiab Electrodiagnostic Medicine (AANEM), cov lus hais txog txoj haujlwm thiab cov lus qhia txog kev xyaum siv koob EMG, kev pheej hmoo ntawm koob electromyography rau cov neeg mob uas siv tshuaj anticoagulants, thiab kev ntsuam xyuas electrodiagnostic ntawm carpal tunnel syndrome thiab radiculopathy.
• Preston DC, Shapiro BE. Electromyography thiab Neuromuscular Disorders: Kev Sib Raug Zoo ntawm Clinical-Electrophysiologic-Ultrasound.
• Kimura J. Kev kuaj mob hluav taws xob hauv cov kab mob ntawm cov hlab ntsha thiab cov leeg: Cov Ntsiab Cai thiab Kev Xyaum.
• American Academy of Neurology, cov kev xyaum ua ntawm kev ntsuam xyuas electrodiagnostic ntawm distal symmetric polyneuropathy thiab carpal tunnel syndrome.
• Txoj Cai Tiv Thaiv Cov Ntaub Ntawv Tus Kheej Digital, 2023 (Tsoomfwv Is Nrias teb), kev tswj hwm cov ntaub ntawv kev noj qab haus huv tus kheej.