D. HOI CHLTNG KENH GUYON
5. Chan doan phan biet
- Chan doan phan biet kieu I vdi hoi chtfng dtfdng ham khuyu tay (cubital tunnel syndrome): lam sang giong nhau nhtfng thtfdng ton day tru d khuyu tay thi toe do dan truyen cua day d khuyu se cham lai va EMG thay co mat phan bo' than kinh d cd thuoc c&ng tay nhtf cd tru trtfdc, cd gap chung sau cac ngon phan danh cho ngon IV va V. Trong hoi chtfng kenh Guyon thi dan truyen cam giac va van dong doan qua khuyu binh thtfdng nhtfng dap tfng cam giac d ngon V lai bat thtfdng. EMG cac cd cang tay binh thtfdng trong khi cac cd nho d ban tay (nhat la cd gian cot I mu tay) lai bat thtfdng.
- Chan doan phan biet kieu I, kieu II, IIA va kieu III.
Bang 4.1: Phan biet cac kieu thtfdng ton trong hoi chifng Guyon
DML day tru DSL day tru EMG cd ADM EMG c<) FDI
Kieu 1 Keo dai Keo dai Bat
thtfdng
Bat thtfdng
Kieu II Keo dai Binh
thtfdng
Bat thtfdng
Bat thtfdng
Kieu IIA Binh
thifdng Binh thtfdng Binh thtfdng Bat thtfdng
Kieu III Binh
thifdng
Keo dai Binh
thtfdng
Binh thtfdng DML: distal motor latency - thdi gian tiem van dong ngoai vi DSL: distal sensory latency - thdi gian tiem cam giac ngoai vi ADM: abdutor digiti - cd dang ngan ngon ut
FDI: firt dorsal interosseous - cd gian cot mu tay 1
6. Dieu tri
- Dieu tri bao ton (xem dieu tri hoi chiing than kinh giiia 0 cd tay).
Khi lam nhiing dong tac gap va xoay ngoai cua cd tay hoac de ep vao gan tay can co thdi gian nghi cach quang.
- Dieu tri phau thuat khi dieu tri bao ton that bai. IV. L IE T DAY TH A N KINH MU (C5, C6)
Hiem gap, thiidng thay trong cac triidng hdp chan thtfdng vung vai.