法医学杂志

法医学杂志 ›› 2012, Vol. 28 ›› Issue (2): 95-99.DOI: 10.3969/j.issn.1004-5619.2012.02.005

• 论著 • 上一篇    下一篇

法医学鉴定中神经传导检测不同参考值的比较

高  东1，田  东2，夏  晴1，朱广友1，范利华1   

  1. （1. 司法部司法鉴定科学技术研究所 上海市法医学重点实验室，上海 200063； 2. 复旦大学附属华山医院手外科，上海 200040）
  • 发布日期:2012-04-25 出版日期:2012-04-28
  • 通讯作者: 通信作者：范利华，女，主任法医师，硕士研究生导师，主要从事法医临床学科研和鉴定工作；E-mail：fanlh@ssfjd.cn
  • 作者简介:高东（1981—），男，山东烟台人，助理研究员，主要从事法医临床学科研和鉴定工作；E-mail：gaod@ssfjd.cn
  • 基金资助:

    上海市科学技术委员会技术标准专项基金资助项目（10DZ0502000）；上海市法医学重点实验室资助项目（11DZ2271500）

Comparisons among Different Reference Values of Nerve Conduction Velocity in Forensic Appraisal

GAO DONG1, TIAN DONG2, XIA QING1, ZHU GUANG-YOU1, FAN LI-HUA1   

  1. （1. Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, P.R.China, Shanghai 200063, China; 2. Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China）
  • Online:2012-04-25 Published:2012-04-28

摘要： 目的 为法医临床学鉴定实践中周围神经传导检测正常参考值的选择提供依据。 方法 选取周围神经正常者114例和周围神经损伤者155例，对双侧肢体的同名神经进行神经传导检测。在正常组中，以左侧肢体的检测结果作为正常参考值，将右侧肢体的检测结果分别与左侧、北京协和医院和上海华山医院推荐的正常参考值进行比较并进行统计。在损伤组中，将伤侧肢体的检测结果分别与健侧、北京协和医院和上海华山医院推荐的正常参考值进行比较并进行统计。 结果 正常组中，左、右侧肢体同名神经的神经传导检测结果之间差异无统计学意义（P>0.05），3种正常参考值选择方法的假阳性率依次为0、11.4%、5.3%，其中假阳性者均被误认为神经轻度损伤。损伤组中，3种正常参考值选择方法的假阴性率依次为0、9.7%、12.3%，其中假阴性者均为神经轻度损伤。 结论 以自身对侧肢体神经传导检测结果作为正常参考值时，可以降低正常者的假阳性率和损伤者的假阴性率。法医学鉴定中周围神经损伤的神经传导检测应当首先选择健侧同名神经的检测结果作为正常参考值，并辅以临床实验室推荐的正常参考值。

关键词: 法医学, 神经传导, 周围神经, 参考值

Abstract: Objective To provide the evidences for the choice of normal reference value of nerve conduction velocity（NCV） in clinical forensic appraisal. Methods One hundred and fourteen cases with normal peripheral nerve and 155 cases with injured peripheral nerve were collected. The NCV of homonymous nerves in two limbs were detected. In the normal cases, the NCV of the left limbs were used as the normal reference values. The NCV of the right limbs were compared with that of left limbs, the commendatory normal reference values from Beijing Xiehe Hospital and Shanghai Huashan Hospital. In the injured cases, the results of NCV in injuried limbs were compared with the results of healthy limbs and the reference values from Beijing Xiehe Hospital and Shanghai Huashan Hospital. Results In the normal group, there was no statistical difference between the left and right limbs in NCV results of homonymous nerve（P>0.05）. The false positive rates（FPR） were 0, 11.4% and 5.2% for three choices normal reference respectively. The false negative rates（FNR） were 0, 9.7% and 12.3% for three choices normal reference in injuried group. The false negative cases were all slight nerve injury. Conclusion The reference value of self-control method could decrease the FPR of normal cases and FNR of injured cases. In clinical forensic appraisal of peripheral nerve, the nerve condition study results from healthy homonymous nerve should be regarded as the reference value at first, supplemented by reference values from clinical labs.

Key words: forensic medicine, neural conduction, peripheral nerves, reference values

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