ﻣﻘﺎﻳﺴﻪ ﺳﻮﻧﻮﮔﺮاﻓﻲ و ﺗﺴﺖ اﻟﻜﺘﺮودﻳﺎﮔﻨﻮﺳﺘﻴﻚ در ﺗﺸﺨﻴﺺ

(1)

__________________________________________________________________

ناﺮﻳا درد و يﺰﺘﺴﻧآ لﺎﻧﻮﻳژر ﻦﻤﺠﻧا

ﻪﻣﺎﻨﻠﺼﻓ ﻲﺸﻫوﮋﭘ ﻲﻤﻠﻋ

هرود ،درد و ﻲﺷﻮﻬﻴﺑ 2

هرﺎﻤﺷ ، 5

ﺰﻴﻳﺎﭘ ، 1390

ﻞﻧﻮﺗ مرﺪﻨﺳ يرﺎﻤﻴﺑ ﺺﻴﺨﺸﺗ رد ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا ﺖﺴﺗ و ﻲﻓاﺮﮔﻮﻧﻮﺳ ﻪﺴﻳﺎﻘﻣ لﺎﭘرﺎﻛ

ﺮﻴﻣا ﻲﻠﻴﻟد ﺎﺿر ﻲﻧادﺮﻣ ﻦﺴﺤﻣ ،1

*يﻮﻴﻛ ﻲﻠﻋ ﺪﻤﺣا ،2 3هداز

نﺎﻴﻤﺗﺎﺣ ﺎﺿرﺪﻴﻤﺣ ، ﻦﻴﺴﺣ ﺮﻔﻈﻣ ،4

5داﮋﻧ ،

ﻲﭘ ﺪﻴﻤﺣ

6مزر ﺐﺣﺎﺻ رﺎﻳﺎﺸﺧ،

يرﺎﻴﺘﺧا ﻲﻤﺷﺎﻫ ناﻮﻴﻛ ،7

7ﻖﻠﻄﻣ

1 . نﻼﻴﮔ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد يژﻮﻟﻮﻳدار رﺎﻳدﺎﺘﺳا ،يژﻮﻟﻮﻳدار ﺺﺼﺨﺘﻣ

2 . نﻼﻴﮔ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد يﺪﭘﻮﺗرا رﺎﻳدﺎﺘﺳا ،يﺪﭘﻮﺗرا ﺺﺼﺨﺘﻣ ﺎﻨﻴﺳرﻮﭘ نﺎﺘﺳرﺎﻤﻴﺑ ،

3 . نﻼﻴﮔ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد يژﻮﻟﻮﻳدار رﺎﻴﺸﻧاد ،يژﻮﻟﻮﻳدار ﺺﺼﺨﺘﻣ

4 . نﻼﻴﮔ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد بﺎﺼﻋا و ﺰﻐﻣ رﺎﻴﺸﻧاد ،بﺎﺼﻋا و ﺰﻐﻣ ﺺﺼﺨﺘﻣ

5 . نﻼﻴﮔ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد بﺎﺼﻋا و ﺰﻐﻣ رﺎﻳدﺎﺘﺳا،بﺎﺼﻋا و ﺰﻐﻣ ﺺﺼﺨﺘﻣ

6 . نﻼﻴﮔ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد يژﻮﻟﻮﻳدار رﺎﻴﺘﺳد

7 . ﻲﻣﻮﻤﻋ ﻚﺷﺰﭘ

__________________________________________________________________________________________________________________________________________

هﺪﻴﻜﭼ

فﺪﻫ و ﻪﻨﻴﻣز :

ﺖﻓﺮﺸﻴﭘ ﻦﻓ رد ﻪﻠﺻﺎﺣ يﺎﻫ لﺎﺳ رد ﻻﺎﺑ ﺖﺳاﺮﺘﻨﻛ ﺎﺑ ﺪﻧﻮﺳاﺮﺘﻟوا يروآ

رد نآ ﻪـﺑ ﺮﺘـﺸﻴﺑ ﻪـﺟﻮﺗ ﺐﺟﻮﻣ ﺮﻴﺧا يﺎﻫ

ﺸﺗ ﺖﺳا هﺪﺷ لﺎﭘرﺎﻛ ﻞﻧﻮﺗ مرﺪﻨﺳ ﺺﻴﺨ .

طﺎـﺒﺗرا و يرﺎـﻤﻴﺑ ﻦـﻳا رد ﻲﻓاﺮﮔﻮﻧﻮـﺳ ﻲـﺼﻴﺨﺸﺗ شزرا ﻲـﺳرﺮﺑ ﻪـﺑ ﺮـﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ

ﻲﻣ ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا سﺎﺳاﺮﺑ يرﺎﻤﻴﺑ تﺪﺷ ﺎﺑ نآ ﻒﻠﺘﺨﻣ يﺎﻫرﺎﻴﻌﻣ دزادﺮﭘ

.

ﻲﺳرﺮﺑ شور :

هﺪﻨﻳآ ﻲﻠﻴﻠﺤﺗ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد ﻚﻳ ﻲﻧﺎﻗﻮﻓ ماﺪﻧا يﺮﻴﮔرد ﻲﮕﻤﻫ رد ﻪﻛ رﺎﻤﻴﺑ ﺪﺻ ﺮﮕﻧ

ﻮﺑ ﻪﻓﺮﻃ راﺮـﻗ ﻪـﻌﻟﺎﻄﻣ درﻮﻣ د

ﺪﻨﺘﻓﺮﮔ .

ﺪـﺷ ضﺮـﻓ ﻲـﻳﻼﻃ دراﺪﻧﺎﺘـﺳا ناﻮﻨﻋ ﻪﺑ نﻮﻣزآ ﻦﻳا و ﻪﺘﻓﺮﮔ راﺮﻗ ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا نﻮﻣزآ ﺖﺤﺗ اﺪﺘﺑا نارﺎﻤﻴﺑ ﻲﻣﺎﻤﺗ .

ﻂـﺳﻮﺗ مﻮﻟﻮﻛﺎـﻨﻴﺗر رﻮـﺴﻜﻠﻓ ﺖﻣﺎﺨﺿ و لﺎﭘرﺎﻛ ﻞﻧﻮﺗ ﻲﺟوﺮﺧ و يدورو رد ﻦﻳﺪﻣ ﺐﺼﻋ ﻲﻔﻠﺧ ﻲﻣاﺪﻗ ﺮﻄﻗ و ﻊﻄﻘﻣ ﺢﻄﺳ ﺲﭙﺳ نارﺎﻤﻴﺑ ﻲﻣﺎﻤﺗ رد ﻲﻓاﺮﮔﻮﻧﻮﺳ ﺪﺷ يﺮﻴﮔ هزاﺪﻧا

. ﻪﺘﻓﺎﻳ طﺎﺒﺗرا راﺰﻓا مﺮﻧ ﺎﺑ ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا و ﻲﻓاﺮﮔﻮﻧﻮﺳ يﺎﻫ

ﻪﺨﺴﻧSPSS 19

ﺪﺷ ﻲﺳرﺮﺑ .

ﻪﺘﻓﺎﻳ ﺎﻫ : ﻞﻣﺎﺷ نارﺎﻤﻴﺑ 84

و نز 16 ﻲﻨﺳ هﺮﺘﺴﮔ رد دﺮﻣ 19

ﺎﺗ 72 لﺎﺳ ) ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ 05

/

±12 43 / 44 لﺎﺳ ( ﺪﻨﺘﺷاد راﺮﻗ .

زا

ﻚﻳدﺰﻧ ﻊﻄﻘﻣ ﺢﻄﺳ رﺎﻴﻌﻣ ود هﺪﺷ ﻲﺳرﺮﺑ يﺎﻫرﺎﻴﻌﻣ ﻦﻴﺑ )

لﺎﻤﻳﺰﮔوﺮﭘ (

رود و ) لﺎﺘﺴﻳد ( ﻲـﻨﻌﻣ طﺎﺒﺗرا ﺐﺼﻋ ﺺﻴﺨـﺸﺗ ﺎـﺑ يراد

ﺪﻧداد نﺎﺸﻧ يرﺎﻤﻴﺑ )

ﺐﻴﺗﺮﺗ ﻪﺑ راﺪﻘﻣ ﺎﺑ ﺮﺑاﺮﺑP 018 / 0 و 022 / 0 ( يرﺎﻣآ طﺎﺒﺗرا ﺰﻴﻧ يرﺎﻤﻴﺑ تﺪﺷ و قﻮﻓ رﺎﻴﻌﻣ ود ﻦﻴﺑ ﻦﻴﻨﭽﻤﻫ

ﻲﻨﻌﻣ يراد ﺪﺷ ﺖﻓﺎﻳ ) راﺪﻘﻣ ود ﺮﻫ زا ﺮﺘﻤﻛP

05 / 0 .(

ﻚﻳدﺰﻧ ﻊﻄﻘﻣ ﺢﻄﺳ رد شﺮﺑ ﻪﻄﻘﻧ ﻦﻳﺮﺘﻬﺑ 45

/ 9 ﻲﻠﻴﻣ ﻪـﻛ دﻮـﺑ ﻊﺑﺮﻣ ﺮﺘﻣ

ﺖﻴﺳﺎﺴﺣ نآ رد 9

/ 78 ﻲﮔﮋﻳو ،ﺪﺻرد 8

/ 82 ﺖـﺒﺜﻣ يرﺎـﺒﺧا شزرا ،ﺪﺻرد 8

/ 91 ﻲـﻔﻨﻣ يرﺎـﺒﺧا شزرا و ﺪـﺻرد 5

/ 61 ﺪـﺻرد

ﺪﻣآ ﺖﺳﺪﺑ .

ﻪﺠﻴﺘﻧ يﺮﻴﮔ : ﻞـﻧﻮﺗ مرﺪﻨـﺳ ﺺﻴﺨـﺸﺗ رد لﺎﭘرﺎﻛ ﻞﻧﻮﺗ يدورو رد ﻦﻳﺪﻣ ﺐﺼﻋ ﻊﻄﻘﻣ ﺢﻄﺳ ﻲﺳرﺮﺑ ﻪﻛ داد نﺎﺸﻧ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ

ﺟﻮﺗ ﺎﺑ و هدﻮﺑ ﺪﻴﻔﻣ لﺎﭘرﺎﻛ رد ﻪـﻜﻠﺑ كﻮﻜـﺸﻣ نارﺎـﻤﻴﺑ ﺺﻴﺨـﺸﺗ رد ﺎـﻬﻨﺗ ﻪﻧ ﻻﺎﺑ ﺖﺒﺜﻣ يرﺎﺒﺧا شزرا و ﻲﮔﮋﻳو ،ﺖﻴﺳﺎﺴﺣ ﻪﺑ ﻪ

لﺎﺑﺮﻏ ﻲﻣ ﺰﻴﻧ ﺮﻄﺧ ضﺮﻌﻣ رد ﻪﻌﻣﺎﺟ يﺮﮔ ﺪﺷﺎﺑ ﺪﻨﻣدﻮﺳ ﺪﻧاﻮﺗ

.

يﺪﻴﻠﻛ نﺎﮔژاو :

زﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا ،ﻲﻓاﺮﮔﻮﻧﻮﺳاﺮﺘﻟوا ،لﺎﭘرﺎﻛ ﻞﻧﻮﺗ مرﺪﻨﺳ

* لﻮﺌﺴﻣ هﺪﻨﺴﻳﻮﻧ سردآ :

ﺖﺷر،يﻮﻴﻛ ﻲﻧادﺮﻣ ﻦﺴﺤﻣ ،

رﺎﺘﺳﺮﭘ نﺎﺑﺎﻴﺧ

، ﺎﻨﻴﺳرﻮﭘ نﺎﺘﺳرﺎﻤﻴﺑ

، ﺎﺿر مﺎﻣا ﻚﻴﻨﻴﻠﻛ )

ع (

ﻚﻴﻧوﺮﺘﻜﻟا ﺖﺴﭘ [email protected] :

(2)

هرود ،درد و ﻲﺷﻮﻬﻴﺑ ﻲﺸﻫوﮋﭘ ﻲﻤﻠﻋ ﻪﻣﺎﻨﻠﺼﻓ 2

هرﺎﻤﺷ ، 5 ﺰﻴﻳﺎﭘ ، 1390 ___________________________________________

ﻪﻣﺪﻘﻣ لﺎﭘرﺎﻛ ﻞﻧﻮﺗ مرﺪﻨﺳ )

Carpal Tunnel

Syndrome (

ﻊﻳﺎﺷ يرﺎﺸﻓ ﻲﺗﺎﭘورﻮﻧ ﻦﻳﺮﺗ

)ﺖﺳا

1 و 2

. (

رﺎﻬﭼ زا ﻲﻜﻳ ،هدﺎﺳ ﺮﻫﺎﻇ ﻪﺑ يرﺎﻤﻴﺑ ﻦﻳا

ﻲﻤﺋاد ﺎﻳ ﺖﻗﻮﻣ ،ﻲﺒﺴﻧ ﻲﮔدﺎﺘﻓارﺎﻛ زا هﺪﻤﻋ ﺖﻠﻋ ﻪﻨﻳﺰﻫ و هدﻮﺑ دوﺪﺣرد يا

5000 ﺮﻫ يازا ﻪﺑ رﻻد

و ﺖﺷاﺪﻬﺑ ﻢﺘﺴﻴﺳ و ﻪﻌﻣﺎﺟ ﻪﺑ ار ﺮﻴﮔرد ﻮﻀﻋ ﺪﻨﻛ ﻲﻣ دراو نﺎﻣرد

) 3 و 4

ﻦﻴﺑ ﻊﻳﺎﺷ ﻦﺳ .(

60 - 30

ﺑ لﺎﺳ و هﺪﺷ دروآﺮ 9

% و نﺎﻧز 6 / 0 % رد نادﺮﻣ زا

ﻲﻣ ﻼﺘﺒﻣ يرﺎﻤﻴﺑ ﻦﻳا ﻪﺑ ﻲﮔﺪﻧز لﻮﻃ ﺪﻧدﺮﮔ

) 5 .(

ﻲﻣ هداد ﻲﻨﻴﻟﺎﺑ ﻢﺋﻼﻋ سﺎﺳاﺮﺑ ﻪﻴﻟوا ﺺﻴﺨﺸﺗ دﻮﺷ

ﺐﺷ ﻪﻛ و ﭻﻣ زا مواﺪﻣ نﺪﻴﺸﻛ رﺎﻛ زا ﺲﭘ و ﺎﻫ

ﻲﻣ ﺪﻳﺪﺸﺗ ﺖﺳد

) ﺪﻧﻮﺷ

6 و 7

.(

نﻮﻣزآ ﻪﻜﻧآ ﺎﺑ يﺎﻫ

ﺺﻴﺨﺸﺗ رد ﻲﻳﻼﻃ دراﺪﻧﺎﺘﺳا ،ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا ظﺎﺤﻟ زا ﻞﻤﻋ زا ﺶﻴﭘ نآ مﺎﺠﻧا و هدﻮﺑ يرﺎﻤﻴﺑ ﺖﺳا يرﺎﺒﺟا ﻲﻧﻮﻧﺎﻗ

) 10 - 8

ﺖﻓﺮﺸﻴﭘ ﻲﻟو (

يﺎﻫ

ﻦﻓ رد ﻪﻠﺻﺎﺣ ﻻﺎﺑ ﺖﺳاﺮﺘﻨﻛ ﺎﺑ ﺪﻧﻮﺳاﺮﺘﻟوا يروآ

نآ يﺪﻣآرﺎﻛ ﻲﺳرﺮﺑ ﻪﺑ ناﺮﮕﺸﻫوﮋﭘ ﺐﻴﻏﺮﺗ ﺐﺟﻮﻣ هﺪﺷ لﺎﭘرﺎﻛ ﻞﻧﻮﺗ مرﺪﻨﺳ ﺺﻴﺨﺸﺗ رد

) ﺖﺳا

2 و 21 -

11

.(

ﻞﻣﺎﺷ ﻲﻓاﺮﮔﻮﻧﻮﺳ ﻦﺘﻓﺮﮔ راﺮﻗ ﻪﺟﻮﺗ درﻮﻣ ﺖﻠﻋ ﻲﺑ د ﻪﻨﻳﺰﻫ و ،ﺮﺘﺸﻴﺑ سﺮﺘﺳد ،ﻲﻤﺟﺎﻬﺗﺮﻴﻏ ،يدر

ﻦﻴﻳﺎﭘ ﺖﺳا نآ ﺮﺗ .

ﻢﻫ ﺮﻳﺎﺳ ﺺﻴﺨﺸﺗ ترﺪﻗ ﻦﻴﻨﭼ

يژﻮﻟﻮﺗﺎﭘ نآ يﺎﻳاﺰﻣ زا ﺮﮕﻳد ﻲﻜﻳ ﻲﻌﺿﻮﻣ يﺎﻫ

)ﺖﺳا

22

.(

ﺎﺑ دﺪﻌﺘﻣ تﺎﻌﻟﺎﻄﻣ مﺎﺠﻧا ﺚﻋﺎﺑ ﻪﻛ ﻪﭽﻧآ

شور لﺎﺳ رد توﺎﻔﺘﻣ يﺎﻫ ،هﺪﺷ ﺮﻴﺧا يﺎﻫ

ﻢﺸﭼ تﺎﻓﻼﺘﺧا هﺪﻣآ ﺖﺳد ﻪﺑ ﺞﻳﺎﺘﻧ ﺮﻴﮔ

) ﻔﻨﻣ ،ﻲﮔﮋﻳو ،ﺖﻴﺳﺎﺴﺣ بذﺎﻛ ﺖﺒﺜﻣ ،بذﺎﻛ ﻲ

( ،

ﺖﻬﺟ ﻞﺤﻣ ﻦﻳﺮﺘﻬﺑ بﺎﺨﺘﻧا درﻮﻣ رد ﺮﻈﻧ فﻼﺘﺧا مﺪﻋ و ﺖﺳد ﭻﻣ ﻪﻴﺣﺎﻧ رد يرﺎﻤﻴﺑ ﺺﻴﺨﺸﺗ شوﺪﺨﻣ ﻞﻣاﻮﻋ لﺮﺘﻨﻛ ﺖﺳا ﻲﻄﻴﺤﻣ هﺪﻨﻨﻛ

.

يروﺮﻣ تﺎﻌﻟﺎﻄﻣ رد ﺎﺗ هﺪﺷ ﺐﺟﻮﻣ ﻞﺋﺎﺴﻣ ﻦﻴﻤﻫ ﺺﻴﺨﺸﺗ شزرا درﻮﻣ رد ﺰﻴﻧ ﻪﺘﻓﺮﮔ مﺎﺠﻧا دﻮﺷ هﺪﻳد ﻲﺸﺣﺎﻓ ﺮﻈﻧ فﻼﺘﺧا ﻲﻓاﺮﮔﻮﻧﻮﺳ

) 2 و 8 (

ﺎﻣا ؛

ﻪﻄﻘﻧ ﻪﺑ زﺎﻴﻧ سﺎﺴﺣا تﺎﻌﻟﺎﻄﻣ ﻦﻳا ﻪﻤﻫ كﺮﺘﺸﻣ

ﻖﻴﻗد و ﺮﺘﺸﻴﺑ تﺎﻌﻟﺎﻄﻣ ﺖﺳا عﻮﺿﻮﻣ ﻦﻳا يور ﺮﺗ

.

ﻲﺼﻴﺨﺸﺗ شزرا ﻦﻴﻴﻌﺗ ﺖﻬﺟ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ يﺎﻫرﺎﻴﻌﻣ طﺎﺒﺗرا و يرﺎﻤﻴﺑ ﻦﻳا رد ﻲﻓاﺮﮔﻮﻧﻮﺳ سﺎﺳاﺮﺑ يرﺎﻤﻴﺑ تﺪﺷ ﺎﺑ ﻲﻓاﺮﮔﻮﻧﻮﺳ ﻒﻠﺘﺨﻣ ﺖﺳا هﺪﺷ ﻲﺣاﺮﻃ ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا .

ﻪﻌﻟﺎﻄﻣ شور

ﻠﻴﻠﺤﺗ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد هﺪﻨﻳآ ﻲ

ﻲﻃ ﻪﻛ ﻲﻧارﺎﻤﻴﺑ ،ﺮﮕﻧ

ﻦﻳدروﺮﻓ 1389

ﻦﻳدروﺮﻓ ﺎﺗ 1390

ﻢﺋﻼﻋ سﺎﺳا ﺮﺑ

ﻲﻨﻴﻟﺎﺑ

، ياﺮﺑ لﺎﭘرﺎﻛ ﻞﻧﻮﺗ مرﺪﻨﺳ ﻪﻴﻟوا ﺺﻴﺨﺸﺗ

نآ ﺪﻨﺘﻓﺮﮔ راﺮﻗ ﻲﺳرﺮﺑ درﻮﻣ ،دﻮﺑ حﺮﻄﻣ ﺎﻫ .

ﻢﺋﻼﻋ

بﺎﺼﻋا و ﺰﻐﻣ و يﺪﭘﻮﺗرا ﺺﺼﺨﺘﻣ ﻂﺳﻮﺗ ﻲﻨﻴﻟﺎﺑ رﻮﻣرﻮﻣ و ﺰﮔﺰﮔ سﺎﺴﺣا ﻞﻣﺎﺷ و هﺪﺷ ﻲﺑﺎﻳزرا ﻲﺑ ﺎﻳ نﺪﺷ ﻲﺴﺣ

ﺐﺼﻋ ﻪﻴﺣﺎﻧ ،ﻦﻳﺪﻣ ﺐﺼﻋ ﻲﻫد

ﻞﻴﻠﺤﺗ ) ﻲﻓوﺮﺗﻮﭙﻴﻫ (

ﻦﺘﻓر ﺖﺳد زا و رﺎﻨﺗ تﻼﻀﻋ

ﻲﻣ ﺖﺳد ﻖﻴﻗد و مﺮﻧ تﺎﻛﺮﺣ دﻮﺷ

. ﻪﻛ ﻲﻧارﺎﻤﻴﺑ

يرﺎﻤﻴﺑ ﻪﻘﺑﺎﺳ ﻲﻠﭘ نﻮﭼ ﻲﺒﺼﻋ ﺮﮕﻳد يﺎﻫ

،ﻲﺗﺎﭘورﻮﻧ

ﻲﺗﺎﭘﻮﻟﻮﻜﻳدار ،ﻦﻳﺪﻣ ﺐﺼﻋ ﻚﻳدﺰﻧ ﻪﻴﺣﺎﻧ ﻲﺗﺎﭘورﻮﻧ ﻪﺴﻔﻗ ﻲﺟوﺮﺧ مرﺪﻨﺳ ،ﻲﻳوزﺎﺑ ﻲﺗﺎﭘﻮﺴﻜﻠﭘ ،ﻲﻧدﺮﮔ ﺸﻓ يﺮﻴﮔرد ﺎﻳ ﻪﻨﻴﺳ ماﺪﻧا بﺎﺼﻋا ﺮﻳﺎﺳ يرﺎ

ﻲﻧﺎﻗﻮﻓ

، ﺪﻧﺪﺷ جرﺎﺧ ﻪﻌﻟﺎﻄﻣ زا .

ﻢﻫ نارﺎﻤﻴﺑ ﻦﻴﻨﭼ

يرﺎﻤﻴﺑ ﻪﻘﺑﺎﺳ ﺮﻈﻧ زا ﻪﻨﻴﻣز يﺎﻫ

ﻢﻛ ﻞﺜﻣ يا يرﺎﻛ

ﺖﺑﺎﻳد ،ﺪﻴﺋﻮﺗﺎﻣور ﺖﻳﺮﺗرآ ،سﻮﭘﻮﻟ ،سﺮﻘﻧ ،ﺪﻴﻳوﺮﻴﺗ ﻲﺳرﺮﺑ ﻲﻟﺎﮕﻣوﺮﻛآ و ﻪﻴﻠﻛ ﻦﻣﺰﻣ ﻲﺋﺎﺳرﺎﻧ ،ﻦﻳﺮﻴﺷ ﻪﻌﻟﺎﻄﻣ زا ﻪﻘﺑﺎﺳ ندﻮﺑ ﺖﺒﺜﻣ ترﻮﺻ رد و هﺪﺷ ﺪﻧﺪﺷ جرﺎﺧ .

هوﻼﻋ ﻪﻘﺑﺎﺳ هﺪﺷ ﺮﻛذ يﺎﻫرﺎﻴﻌﻣ ﺮﺑ

ﻪﺘﺷﺬﮔ رد ﺖﺳد ﭻﻣ ﻲﺣاﺮﺟ و ﻲﮕﺘﺴﻜﺷ ،ﺎﻣوﺮﺗ ﻪﺘﻓﺮﮔ ﺮﻈﻧ رد ﻪﻌﻟﺎﻄﻣ زا جوﺮﺧ رﺎﻴﻌﻣ ناﻮﻨﻋ ﻪﺑ ﺰﻴﻧ ﺪﺷ . نﻮﻣزآ ﺖﺤﺗ نارﺎﻤﻴﺑ اﺪﺘﺑا رد يﺎﻫ

ﺪﻨﺘﻓﺮﮔ راﺮﻗ ﻚﻳژﻮﻟﻮﻳﺰﻴﻓوﺮﺘﻜﻟا .

ﺮﻈﻧ فﺮﺻ ،ﺲﭙﺳ

ﻲﻓاﺮﮔﻮﻧﻮﺳ نارﺎﻤﻴﺑ ﻦﻳا ﻲﻣﺎﻤﺗ ،ﻪﻠﺻﺎﺣ ﻪﺠﻴﺘﻧ زا ﺪﻧﺪﺷ .

(3)

45

_{نارﺎﻜﻤﻫ و}_ﻲ_ﻠ_ﻴ_{ﻟد ﺎﺿر}_ﺮﻴﻣ_ا

حﺮﻃ ياﺮﺟا زﻮﺠﻣ ﻲﺸﻫوﮋﭘ ﺖﻧوﺎﻌﻣ يﻮﺳ زا

ﺪﺷ ردﺎﺻ نﻼﻴﮔ ﻲﻜﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد .

ﻂﺑاﻮﺿ

ﻲﻗﻼﺧا يﺎﻫدراﺪﻧﺎﺘﺳا سﺎﺳاﺮﺑ ﻲﺼﻴﺨﺸﺗ )

ﻪﻴﻧﺎﻴﺑ

ﻲﻜﻨﻴﺴﻠﻫ 1975

( نارﺎﻤﻴﺑ ﻲﻣﺎﻤﺗ زا و هﺪﺷ ﻦﻳوﺪﺗ

ﺪﺷ ﺬﺧا ﻪﻧﺎﻫﺎﮔآ ﺖﻳﺎﺿر مﺮﻓ .

ﺮﺛا ﺶﻫﺎﻛ ﺖﻬﺟ

رد ﻪﻛ ﻲﻧارﺎﻤﻴﺑ ،يﺮﻴﮔدﺎﻳ ﻲﻨﺤﻨﻣ 3

لوا ﻪﻫﺎﻣ

ﻲﻓاﺮﮔﻮﻧﻮﺳ ﺎﺑ ﻲﺳرﺮﺑ درﻮﻣ ﻪﻌﻟﺎﻄﻣ زا ﺪﻨﺘﻓﺮﮔ راﺮﻗ

ﺪﻧﺪﺷ جرﺎﺧ ﻪﻌﻟﺎﻄﻣ .

ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا نﻮﻣزآ :

ﻲﻠﺧاد ﺺﺼﺨﺘﻣ ﻂﺳﻮﺗ ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا نﻮﻣزآ ﺪﺷ مﺎﺠﻧا ﺮﻫﺎﻣ بﺎﺼﻋا .

ﻦﻳا يﺎﻣد ﺎﺑ قﺎﺗا رد رﺎﻛ

ﺰﻴﻧ ﺖﺳﻮﭘ ﺢﻄﺳ يﺎﻣد و هﺪﺷ مﺎﺠﻧا ﻲﻟﻮﻤﻌﻣ ﻦﻴﺑ و هﺪﺷ لﺮﺘﻨﻛ 32

ﺎﺗ 34 دﻮﺑ ﻪﺟرد .

شور

هداد ﺖﺒﺛ و نﻮﻣزآ مﺎﺠﻧا زا ﻞﺻﺎﺣ يﺎﻫ

ﻖﺑﺎﻄﻣ نآ

ﻲﻠﺒﻗ تﺎﻌﻟﺎﻄﻣ رد هﺪﺷ ﻪﻴﺻﻮﺗ دراﺪﻧﺎﺘﺳا )

25 - 23 (

ﺪﺷ ﻲﺣاﺮﻃ .

ﻲﺴﺣ ﺐﺼﻋ ﻞﻤﻋ ﻞﻴﺴﻧﺎﺘﭘ اﺪﺘﺑا

Sensory Nerve Action Potential (SNAP) ﻲﺘﻛﺮﺣ ﺮﻴﺧﺄﺗ و

رود Distal Motor

Latency (AML) نﺎﺘﺸﮕﻧا رد ﻦﻳﺪﻣ ﺐﺼﻋ

ﺖﺸﮕﻧا رد رﺎﻨﻟوا ﺐﺼﻋ رد ﺲﭙﺳ و مﻮﺳ ﺎﺗ لوا ﺪﺷ مﺎﺠﻧا ﻢﺠﻨﭘ .

ﻢﻫ ﺳ ﻦﻴﻨﭼ ﺐﺼﻋ ﺖﻳاﺪﻫ ﺖﻋﺮ

ﻲﺴﺣ Sensory Nerve Conduction

Velocity (SNCV) ﺖﺳد ﻒﻛ و ﭻﻣ ﻦﻴﺑ

هزاﺪﻧا ﺪﺷ يﺮﻴﮔ .

ﻪﺘﻓﺎﻳ ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد ﺖﺒﺜﻣ يﺎﻫ

ﻞﻣﺎﺷ لﺎﭘرﺎﻛ ﻞﻧﻮﺗ مرﺪﻨﺳ ﺺﻴﺨﺸﺗ ياﺮﺑ :

ﻦﻴﮕﻧﺎﻴﻣ زا ﺮﺘﻤﻛ SNCV

45 ،ﻪﻴﻧﺎﺛ ﺮﺑ ﺮﺘﻣ

DML زا ﺶﻴﺑ 2 / 4 ﻲﻠﻴﻣ و ﻪﻴﻧﺎﺛ ﺮﺘﻤﻛSNAP

زا 15 ﺪﺷ ﻪﺘﻓﺮﮔ ﺮﻈﻧ رد ﺖﻟووﺮﻜﻴﻣ .

سﺎﺳاﺮﺑ

ﻪﺘﻓﺎﻳ نﻮﻣزآ يﺎﻫ هوﺮﮔ رﺎﻬﭼ ﻪﺑ نارﺎﻤﻴﺑ رﻮﻛﺬﻣ يﺎﻫ

ﺪﻧﺪﺷ ﻢﻴﺴﻘﺗ ﺪﻳﺪﺷ و ﻂﺳﻮﺘﻣ ،ﻒﻴﻔﺧ ،ﻲﻌﻴﺒﻃ .

ﻪﺑ

هوﺮﮔ ﺮﻳﺎﺳ ﻲﻌﻴﺒﻃ هوﺮﮔ ﺰﺟ ﻪﺘﻓﺮﮔ ﺮﻈﻧ رد رﺎﻤﻴﺑ ﺎﻫ

ﺪﻧﺪﺷ . ﻲﻌﻴﺒﻃ

: نﻮﻣزآ ﻪﻤﻫ ﻲﻌﻴﺒﻃ ﺎﻫ

ﻒﻴﻔﺧ : رد يﺪﻨﻛ وSNCV

ﻲﻌﻴﺒﻃDML

ﻂﺳﻮﺘﻣ : رد يﺪﻨﻛ SNCV

و هﺪﻴﺸﻛ لﻮﻃDML

ﺪﻳﺪﺷ : و ﻲﺴﺣ ﺦﺳﺎﭘ دﻮﺒﻧ هﺪﻴﺸﻛ لﻮﻃ DML

دﻮﺒﻧ ﺎﻳ DML

ﻲﻓاﺮﮔﻮﻧﻮﺳ ﻲﺑﺎﻳزرا :

ﺲﻧﺎﻛﺮﻓ ﺎﺑ ﻲﻄﺧ بوﺮﭘ ﻚﻳ ﻪﻠﻴﺳو ﻪﺑ ﻲﻓاﺮﮔﻮﻧﻮﺳ 10 - 6 / 6 ﺎﮕﻣ ﺰﺗﺮﻫ ) لﺪﻣ Ultrasonix ver.SP (

نﻮﻣزآ مﺎﺠﻧا زور نﺎﻤﻫ رد ﻚﻳژﻮﻟﻮﻳﺰﻴﻓوﺮﺘﻜﻟا يﺎﻫ

ﺪﺷ مﺎﺠﻧا .

هزاﺪﻧا ﻲﻣﺎﻤﺗ يﺮﻴﮔ

ﻚﻳ ﻂﺳﻮﺗ ﺎﻫ

ﺨﺘﻣ ،ﻢﺋﻼﻋ زا ﻪﻛ ﺖﻓﺮﮔ ترﻮﺻ يژﻮﻟﻮﻳدار ﺺﺼ

ﻲﺑ ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا ﺞﻳﺎﺘﻧ و تﺎﻨﻳﺎﻌﻣ دﻮﺑ عﻼﻃا

.

ﺞﻧرآ ،هﺪﻴﺸﻛ زارد ﺖﺸﭘ ﻪﺑ رﺎﻤﻴﺑ ﻲﻓاﺮﮔﻮﻧﻮﺳ ﺖﻬﺟ راﺮﻗ ﻦﻳﺎﭘﻮﺳ ﺖﻴﻌﺿو رد ﺖﺳد ﻒﻛ و ﺪﻋﺎﺳ و زﺎﺑ ﻲﻣ دﺮﻴﮔ . نﺎﺘﺸﮕﻧا و ﻞﻣﺎﻛ ﺖﺣاﺮﺘﺳا ﺖﻟﺎﺣ رد ﭻﻣ

ﺪﻧدﻮﺑ هﺪﻴﻤﺧ ﻪﻤﻴﻧ .

رد ،رﺎﻤﻴﺑ ﺖﺳد ود ﺮﻫ رد

ذﺎﺤﻣ رﺎﻨﻟواﻮﻳدار ﻞﺼﻔﻣ تا )

لﺎﭘرﺎﻛ ﻞﻧﻮﺗ يدورو (

ﻲﻣاﺪﻗ ﺮﻄﻗ -

رد و ﺐﺼﻋ ﻊﻄﻘﻣ ﺢﻄﺳ و ﻲﻔﻠﺧ

ﻲﺸﻜﭼ ناﻮﺨﺘﺳا بﻼﻗ تاذﺎﺤﻣ )

ﻞﻧﻮﺗ ﻲﺟوﺮﺧ

لﺎﭘرﺎﻛ ( و ﺐﺼﻋ ﻊﻄﻘﻣ ﺢﻄﺳ ،ﻲﻔﻠﺧ ﻲﻣاﺪﻗ ﺮﻄﻗ

ﻢﻫ ﻪﺒﺳﺎﺤﻣ مﻮﻟﻮﻛﺎﻨﻴﺗر رﻮﺴﻜﻠﻓ ﺖﻣﺎﺨﺿ ﻦﻴﻨﭼ

ﺪﻧﺪﺷ . هزاﺪﻧا شور ود ﻪﺑ ﻦﻳﺪﻣ ﺐﺼﻋ ﻊﻄﻘﻣ ﺢﻄﺳ

ﺪﺷ يﺮﻴﮔ :

ﻲﻣاﺪﻗ ﺮﻄﻗ لوا -

ﻲﻔﻠﺧ (D1) ﺮﻄﻗ و

ﻲﻠﺧاد - ﻲﺟرﺎﺧ (D2) هزاﺪﻧا ﺢﻄﺳ و هﺪﺷ يﺮﻴﮔ

لﻮﻣﺮﻓ ﺎﺑ ﻊﻄﻘﻣ مود ؛ﺪﺷ ﻪﺒﺳﺎﺤﻣ .

ﻲﻄﻴﺤﻣ زﺮﻣ ﺐﻴﻘﻌﺗ (Continuous boundary

tracing)

ﻂﺳﻮﺗ ﻊﻄﻘﻣ ﺢﻄﺳ و هﺪﺷ مﺎﺠﻧا

ﺪﺷ ﻪﺒﺳﺎﺤﻣ هﺎﮕﺘﺳد .

ﺖﺳد ﻪﺑ دﺪﻋ ود ﻦﻴﮕﻧﺎﻴﻣ

درﻮﻣ ﻪﻴﺣﺎﻧ رد ﺐﺼﻋ ﻊﻄﻘﻣ ﺢﻄﺳ ناﻮﻨﻋ ﻪﺑ هﺪﻣآ ﺪﺷ ﻪﺘﻓﺮﮔ ﺮﻈﻧ رد ﻲﺳرﺮﺑ .

ﺖﺳد ﺮﻫ ﻲﺳرﺮﺑ رد

يﺰﺘﺳرﺎﭘ و درد سﺎﺴﺣا دﺎﺠﻳا زا يﺮﻴﮕﺸﻴﭘ ﺖﻬﺟ رﺎﻤﻴﺑ رد

، يور بوﺮﭘ نزو زا ﺶﻴﺑ ﻲﻧزو و رﺎﺸﻓ

(4)

و ﺪﺸﻧ دراو ﻲﺳرﺮﺑ درﻮﻣ ﻞﺤﻣ ﺮﻫ ﻲﺳرﺮﺑ نﺎﻣز

زا ﺖﺳد 15 ﻪﻘﻴﻗد ﺪﺸﻧ ﺮﺘﺸﻴﺑ .

ﻪﻣﺎﻨﺸﺳﺮﭘ رد ﻲﺘﻴﻌﻤﺟ تﺎﺼﺨﺸﻣ يا

) ،ﺲﻨﺟ ،ﻦﺳ

ﺐﻟﺎﻏ ﺖﺳد و ﺮﻴﮔرد ﺖﺳد (

ﻪﺘﻓﺎﻳ و يﺎﻫ

ﺖﺒﺛ نارﺎﻤﻴﺑ ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا و ﻲﻓاﺮﮔﻮﻧﻮﺳ ﺪﺷ . يرﺎﻣآ ﻞﻴﻠﺤﺗ و ﻪﻳﺰﺠﺗ شور :

و ﻖﻠﻄﻣ ﻲﻧاواﺮﻓ زا ،ﻲﻔﻴﻛ يﺎﻫﺮﻴﻐﺘﻣ ﻒﻴﺻﻮﺗ ﺖﻬﺟ يﺎﻫ ﺺﺧﺎﺷ زا ﻲﻤﻛ يﺎﻫﺮﻴﻐﺘﻣ ياﺮﺑ ﻲﺒﺴﻧ ﻦﻴﮕﻧﺎﻴﻣ ﺪﺷ هدﺎﻔﺘﺳا رﺎﻴﻌﻣ فاﺮﺤﻧا ±

. ﻦﺘﻓﺎﻳ ياﺮﺑ

شﺮﺑ ﻪﻄﻘﻧ ﻦﻳﺮﺘﻬﺑ (Cut of point)

ﻪﺷﻮﮔ زا

رادﻮﻤﻧ يﻻﺎﺑ ﭗﭼ ROC)

Receiver

Operating Characteristic (

سﺎﺳاﺮﺑ ﻪﻛ

ﻪﺘﻓﺎﻳ ﻢﺳر ﻲﻓاﺮﮔﻮﻧﻮﺳ يﺎﻫ دﻮﺑ هﺪﺷ

. ﻦﺘﻓﺎﻳ ياﺮﺑ

ﻪﺘﻓﺎﻳ ﻦﻴﺑ طﺎﺒﺗرا و ﻲﻓاﺮﮔﻮﻧﻮﺳ يﺎﻫ

ﻲﻳودود ﻲﻘﻄﻨﻣ ﺶﻫﺎﻛ لﺪﻣ ،ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا ) Binary Logistic Regression (

رﺎﻛ ﻪﺑ

ﺪﺷ ﻪﺘﻓﺮﮔ .

ﻲﻨﻌﻣ ﺢﻄﺳ راﺪﻘﻣ يراد

زا ﺮﺘﻤﻛ P

05 / 0 ﺪﺷ ﻪﺘﻓﺮﮔ ﺮﻈﻧ رد .

ﻞﻴﻠﺤﺗ و ﻪﻳﺰﺠﺗ قﻮﻓ يﺎﻫ

راﺰﻓا مﺮﻧ زا هدﺎﻔﺘﺳا ﺎﺑ ﻪﺨﺴﻧ SPSS

19 ترﻮﺻ

ﮔ ﺖﻓﺮ و

رﺎﻬﭼ ﻞﻣﺎﻋ

رﺎﻣآ ي : و ﻲﮔﮋﻳ

(Specificity)

، ﺣ ﺳﺎﺴ (Sensitivity) ﺖﻴ

،

ﺖﺒﺜﻣ يرﺎﺒﺧا شزرا Positive) Predictive

Value و (PPV

ﻲﻔﻨﻣ يرﺎﺒﺧا شزرا

Negative Predictive Value)

(NPV

ﻪﻧﺎﮔاﺪﺟ رﻮﻃ ﻪﺑ ﻲﻓاﺮﮔﻮﻧﻮﺳ ﻊﻄﻘﻣ ﺮﻫ ياﺮﺑ ﺪﻧﺪﺷ ﻪﺒﺳﺎﺤﻣ .

ﻪﺘﻓﺎﻳ ﺎﻫ رﺎﻤﻴﺑ ﺪﺻ )

84 و نز 16 دﺮﻣ ( ﻪﻛ ﻲﮕﻤﻫ رد

ﻚﻳ ﻲﻧﺎﻗﻮﻓ ماﺪﻧا يﺮﻴﮔرد ﻪﻌﻟﺎﻄﻣ درﻮﻣ دﻮﺑ ﻪﻓﺮﻃ

ﻲﻨﺳ هﺮﺘﺴﮔ رد ﻪﻛ ﺪﻨﺘﻓﺮﮔ راﺮﻗ 19

ﺎﺗ 72 لﺎﺳ

) ﻲﻨﺳ ﻦﻴﮕﻧﺎﻴﻣ 05

/

±12 43 / 44 لﺎﺳ ( راﺮﻗ ﺪﻨﺘﺷاد

. نارﺎﻤﻴﺑ ﻦﻳا داﺪﻌﺗ ﻦﻳﺮﺘﺸﻴﺑ )

37 ﺮﻔﻧ ( رد

ﻦﻴﻨﺳ 41 ﺎﺗ 50 ﺪﻨﺘﺷاد راﺮﻗ لﺎﺳ .

ﺞﻳﺎﺘﻧ سﺎﺳاﺮﺑ

ﻦﻳا زا ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا 100

ﺮﻔﻧ 29 ﺮﻔﻧ ) 29

ﺪﺻرد ( رد يﺮﻴﮔرد تﺪﺷ و هدﻮﺑ ﻲﻌﻴﺒﻃ 44

ﺮﻔﻧ

ﻒﻴﻔﺧ ) 44 ﺪﺻرد ( رد ، 13 ﻂﺳﻮﺘﻣ ﺮﻔﻧ )

13

ﺪﺻرد ( رد و 14 ﺪﻳﺪﺷ ﺮﻔﻧ )

14 ﺪﺻرد ( دﻮﺑ .

ﻲﻨﺤﻨﻣ ROC يﺎﻫ

ﻪﺘﻓﺎﻳ سﺎﺳاﺮﺑ ﻲﻓاﺮﮔﻮﻧﻮﺳ يﺎﻫ

رد 5 هﺪﻣآ ﻚﻳ رادﻮﻤﻧ رد ،ﻲﺳرﺮﺑ درﻮﻣ ﻊﻄﻘﻣ

ﺖﺳا . ﻲﻨﺤﻨﻣ يﺎﻫ ﻪﺘﻓﺎﻳ سﺎﺳا ﺮﺑ ROC

ﻪﻄﻘﻧ ﻦﻳﺮﺘﻬﺑ

ﺮﻫ رد شﺮﺑ زا ﻚﻳ

5 ﺖﺳﺪﺑ ﻲﺳرﺮﺑ درﻮﻣ ﻊﻄﻘﻣ -

ﺪﻣآ . ﺐﺼﻋ ﻚﻳدﺰﻧ ﻊﻄﻘﻣ ﺢﻄﺳ ﻲﺳرﺮﺑ رد )

يدورو

لﺎﭘرﺎﻛ ﻞﻧﻮﺗ (

45 / 9 ﻲﻠﻴﻣ دﻮﺑ ﻊﺑﺮﻣ ﺮﺘﻣ .

دﺪﻋ ﻦﻳا

ﺐﺼﻋ رود ﻊﻄﻘﻣ ﺢﻄﺳ درﻮﻣ رد )

ﻞﻧﻮﺗ ﻲﺟوﺮﺧ

لﺎﭘرﺎﻛ ( 85 / 9 ﻲﻠﻴﻣ ﻲﻔﻠﺧ ﻲﻣاﺪﻗ ﺮﻄﻗ ،ﻊﺑﺮﻣ ﺮﺘﻣ

ﺐﺼﻋ ﻚﻳدﺰﻧ 22

/ 2 ﻲﻠﻴﻣ ﻲﻔﻠﺧ ﻲﻣاﺪﻗ ﺮﻄﻗ ،ﺮﺘﻣ

ﺐﺼﻋ لﺎﺘﺴﻳد 67

/ 2 ﻲﻠﻴﻣ ﺖﻣﺎﺨﺿ درﻮﻣ رد و ﺮﺘﻣ

مﻮﻟﻮﻛﺎﻨﻴﺗر 11

/ 1 ﻲﻠﻴﻣ دﻮﺑ ﺮﺘﻣ . ﻪﺘﻓﺎﻳ سﺎﺳا ﺮﺑ ﺎﻫ

ﻲﻔﻨﻣ و ﺖﺒﺜﻣ يرﺎﺒﺧا شزرا شﺮﺑ طﺎﻘﻧ ﻦﻴﻤﻫ رد ﺖﺳﺪﺑ ﻲﺳرﺮﺑ درﻮﻣ ﻊﻃﺎﻘﻣ زا ﻚﻳ ﺮﻫ ﺪﻣآ

) لوﺪﺟ

1 .(

ﺢﻄﺳ رﺎﻴﻌﻣ ود هﺪﺷ ﻲﺳرﺮﺑ يﺎﻫرﺎﻴﻌﻣ ﻦﻴﺑ زا طﺎﺒﺗرا ﺐﺼﻋ رود و ﻚﻳدﺰﻧ ﻊﻄﻘﻣ ﻲﻨﻌﻣ

يراد ﺎﺑ

ﻧداد نﺎﺸﻧ يرﺎﻤﻴﺑ ﺺﻴﺨﺸﺗ ﺪ

) ﺐﻴﺗﺮﺗ ﻪﺑ ﺮﺑاﺮﺑ P

018 / 0 و 022 / 0 (.

ﻢﻫ و قﻮﻓ رﺎﻴﻌﻣ ود ﻦﻴﺑ ﻦﻴﻨﭼ

يرﺎﻣآ طﺎﺒﺗرا ﺰﻴﻧ يرﺎﻤﻴﺑ تﺪﺷ يراد ﻲﻨﻌﻣ

ﺖﻓﺎﻳ

ﺪﺷ ) ود ﺮﻫ زا ﺮﺘﻤﻛP

05 / 0 .(

شزرا هﺪﻨﻫد نﺎﺸﻧ ﻪﻠﺻﺎﺣ ﺞﻳﺎﺘﻧ ﻪﻜﻨﻳا ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﺖﻤﺴﻗ رد ﺐﺼﻋ ﻊﻄﻘﻣ ﺢﻄﺳ ﺮﺘﺸﻴﺑ ﺺﻴﺨﺸﺗ ﻚﻳدﺰﻧ ) لﺎﻤﻳﺰﮔوﺮﭘ (

ﻲﺳرﺮﺑ ﻪﺑ دﻮﺑ لﺎﭘرﺎﻛ ﻞﻧﻮﺗ

ﻪﺘﻓﺎﻳ ﻦﻴﺑ طﺎﺒﺗرا ﺎﺑ ﻊﻄﻘﻣ ﻦﻳا رد ﻲﻓاﺮﮔﻮﻧﻮﺳ يﺎﻫ

ﻢﻴﺘﺧادﺮﭘ يرﺎﻤﻴﺑ تﺪﺷ .

و ﻂﺳﻮﺘﻣ دراﻮﻣ ياﺮﺑ

ﻊﻄﻘﻣ ﺢﻄﺳ شﺮﻳ ﻪﻄﻘﻧ ﻦﻳﺮﺘﻬﺑ يرﺎﻤﻴﺑ ﺪﻳﺪﺷ

(5)

47

2 / 12 ﻲﻠﻴﻣ ﺪﻳﺪﺷ ﺎﻓﺮﺻ دراﻮﻣ ياﺮﺑ و ﻊﺑﺮﻣ ﺮﺘﻣ

75 / 12 ﻲﻠﻴﻣ ﺪﻣآ ﺖﺳﺪﺑ ﻊﺑﺮﻣ ﺮﺘﻣ .

طﺎﻘﻧ ﻦﻳا ﺎﺑ

ﺐﻴﺗﺮﺗ ﻪﺑ ﻲﮔﮋﻳو و ﺖﻴﺳﺎﺴﺣ ،شﺮﺑ 8

/ 77 و 2 / 93 اﻮﻣ ياﺮﺑ

و ﺪﻳﺪﺷ و ﻂﺳﻮﺘﻣ در 7

/ 85 و 7 / 90 ياﺮﺑ

ﺪﺷ ﻪﺒﺳﺎﺤﻣ ﺪﻳﺪﺷ دراﻮﻣ )

لوﺪﺟ 2 .(

رادﻮﻤﻧ - 1 : ﻲﻨﺤﻨﻣ ﻲﻓاﺮﮔﻮﻧﻮﺳ ﻒﻠﺘﺨﻣ رﺎﻴﻌﻣ ﺞﻨﭘROC

لوﺪﺟ - 1 : ﻪﺘﻓﺎﻳ ﻲﺳرﺮﺑ درﻮﻣ رﺎﻴﻌﻣ ﺞﻨﭘ رد ﻲﻓاﺮﮔﻮﻧﻮﺳ يﺎﻫ

ﻲﻔﻨﻣ بذﺎﻛ

) ﺪﺻرد (

ﺖﺒﺜﻣ بذﺎﻛ

) ﺪﺻرد (

شزرا يرﺎﺒﺧا

ﻲﻔﻨﻣ

) ﺪﺻرد (

شزرا يرﺎﺒﺧا

ﺖﺒﺜﻣ

) ﺪﺻرد (

ﻲﮔﮋﻳو

) ﺪﺻرد (

ﺖﻴﺳﺎﺴﺣ

) ﺪﺻرد (

شﺮﺑ ﻪﻄﻘﻧ

ﻲﻓاﺮﮔﻮﻧﻮﺳ رﺎﻴﻌﻣ

15 5 61/5 91/8 82/8 78/9 ﻊﺑﺮﻣ ﺮﺘﻣﻲﻠﻴﻣ9/45 ﻚﻳدﺰﻧ ﻊﻄﻘﻣ ﺢﻄﺳ

22 2 55/1 96/1 93/1 69 ﻊﺑﺮﻣ ﺮﺘﻣﻲﻠﻴﻣ9/85 رود ﻊﻄﻘﻣ ﺢﻄﺳ

30 5 44/4 89/1 82/8 57/7 ﺮﺘﻣﻲﻠﻴﻣ2/22 ﻚﻳدﺰﻧ ﺮﻄﻗ

27 5 47/1 89/8 82/8 62 ﺮﺘﻣﻲﻠﻴﻣ2/29 رود لﺎﺘﺴﻳد ﺮﻄﻗ

30 4 45/5 91/1 86/2 57/7 ﺮﺘﻣﻲﻠﻴﻣ1/11 مﻮﻟﻮﻛﺎﻨﻴﺗر ﺖﻣﺎﺨﺿ

ﺚﺤﺑ تﻻﻼﺘﺧا ﺺﻴﺨﺸﺗ و ﻲﺑﺎﻳزرا رد ﻲﻓاﺮﮔﻮﻧﻮﺳ ﺶﻘﻧ ﻲﻧﻼﻀﻋ ﻢﺘﺴﻴﺳ -

ﮓﻧرﺮﭘ زور ﻪﺑ زور ﻲﺘﻠﻜﺳا ﺮﺗ

ﻲﻣ دﻮﺷ . گﻮﺑ ﻪﻛ ﻲﻧﺎﻣز زا نارﺎﻜﻤﻫ و ﺰﮔﺮﺑ

) 23 و 24 (

رد ﻦﻳﺪﻣ ﺐﺼﻋ ﻚﻴﻣﻮﺗﺎﻧآ تاﺮﻴﻴﻐﺗ رﺎﺑ ﻦﻴﻟوا ياﺮﺑ درﻮﻣ ﻲﻓاﺮﮔﻮﻧﻮﺳ ﺎﺑ ار لﺎﭘرﺎﻛ ﻞﻧﻮﺗ مرﺪﻨﺳ يرﺎﻤﻴﺑ ﻲﻔﻠﺘﺨﻣ ﻚﻴﻓاﺮﮔﻮﻧﻮﺳ يﺎﻫرﺎﻴﻌﻣ ،ﺪﻧدادراﺮﻗ ﻲﺳرﺮﺑ لﺎﭘرﺎﻛ ﻞﻧﻮﺗ مرﺪﻨﺳ ﺺﻴﺨﺸﺗ و ﻲﺑﺎﻳزرا ﺖﻬﺟ

هﺪﺷ دﺎﻬﻨﺸﻴﭘ ﺖﺳا

. ،ﻒﻠﺘﺨﻣ يﺎﻫرﺎﻴﻌﻣ ﻦﻴﺑ زا

ﻞﻧﻮﺗ ﻲﺟوﺮﺧ و يدورو رد ﺐﺼﻋ ﻊﻄﻘﻣ ﺢﻄﺳ ﺘﻬﺑ پرﺎﻛ ﻪﺘﺷادﺮﺑرد ار ﺞﻳﺎﺘﻧ ﻦﻳﺮ

) ﺪﻧا

2

.(

ﻦﻳا ﺞﻳﺎﺘﻧ

ﺪﻧدﻮﺑ ﻪﻟﺎﺴﻣ ﻦﻴﻤﻫ زا ﻲﻛﺎﺣ ﺰﻴﻧ ﻪﻌﻟﺎﻄﻣ .

ﻦﻳا رد

ﻊﻄﻘﻣ ﺢﻄﺳ ﻪﻌﻟﺎﻄﻣ 45

/ 9 ﻲﻠﻴﻣ رد ﻊﺑﺮﻣ ﺮﺘﻣ

(6)

ﻚﻳدﺰﻧ ﺖﻤﺴﻗ )

لﺎﻤﻴﺴﻛوﺮﭘ (

پرﺎﻛ ﻞﻧﻮﺗ

ﺺﻴﺨﺸﺗ رد ﻲﻟﻮﺒﻗ ﻞﺑﺎﻗ ﻲﮔﮋﻳو و ﺖﻴﺳﺎﺴﺣ ﺢﻄﺳ ﻦﻳا ﻪﻛ داد نﺎﺸﻧ دﻮﺧ زا پرﺎﻛ ﻞﻧﻮﺗ مرﺪﻨﺳ ﻪﺘﻓﺎﻳ ﺎﺑ ﻊﻄﻘﻣ ﻧاو يﺎﻫ

)ﮓ

25

هرﺎﺘﺳﺎﭘ ،( )

26

ﻮﺠﻧارﺎﻧ ،(

) 27

ﮓﻧو و ( ) 28

ﻢﻫ (

دراد ﻲﻧاﻮﺧ .

زا ﻲﺧﺮﺑ رد

تﺎﻌﻟﺎﻄﻣ )

32 - 30 ( ﻢﺸﭼ رﻮﻃ ﻪﺑ شﺮﺑ ﻪﻄﻘﻧ يﺮﻴﮔ

گرﺰﺑ ﻲﻣ ﻦﻳا ﻪﻛ هﺪﺷ ﻦﻴﻴﻌﺗ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ زا ﺮﺗ -

جرﺎﺧ ﻞﻴﻟد ﻪﺑ ﺪﻧاﻮﺗ ﺞﻳﺎﺘﻧ ﺎﺑ نارﺎﻤﻴﺑ ندﺮﻛ

ﻒﻴﻔﺧ يرﺎﻤﻴﺑ ﺎﺑ ﺎﻳ ﻲﻌﻴﺒﻃ ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا ﺪﺷﺎﺑ . ﻚﻴﻨﻜﺗ ﻪﺑ ﻪﺘﺴﺑ لﺮﺘﻨﻛ ناﺰﻴﻣ ،ﻲﻓاﺮﮔﻮﻧﻮﺳ

جوﺮﺧ و دورو يﺎﻫرﺎﻴﻌﻣ و ﻲﻄﻴﺤﻣ ﻂﻳاﺮﺷ ﻲﮔﮋﻳو و ﺖﻴﺳﺎﺴﺣ زا ﻲﺗوﺎﻔﺘﻣ ﺞﻳﺎﺘﻧ ،تﺎﻌﻟﺎﻄﻣ ﺖﺳﺪﺑ پرﺎﻛ ﻞﻧﻮﺗ مرﺪﻨﺳ ﺺﻴﺨﺸﺗ رد ﻲﻓاﺮﮔﻮﻧﻮﺳ هﺪﻣآ ﺪﺳﺮﻴﻣ ﺮﻈﻧ ﻪﺑ عﻮﻤﺠﻣ رد ﻲﻟو ﺖﺳا رد ﻲﻟﻮﺒﻗ ﻞﺑﺎﻗ ﻲﮔﮋﻳو و ﺖﻴﺳﺎﺴﺣ ﻲﻓاﺮﮔﻮﻧﻮﺳ

دراد لﺎﭘرﺎﻛ ﻞﻧﻮﺗ مرﺪﻨﺳ ﺺﻴﺨﺸﺗ .

لوﺪﺟ 2 : ﻪﺘﻓﺎﻳ يرﺎﻤﻴﺑ تﺪﺷ ﻚﻴﻜﻔﺗ ﻪﺑ ﻲﻓاﺮﮔﻮﻧﻮﺳ يﺎﻫ

لوﺪﺟ 3 : ﻪﺘﻓﺎﻳ تﺎﻌﻟﺎﻄﻣ ﺮﻳﺎﺳ ﻲﻓاﺮﮔﻮﻧﻮﺳ يﺎﻫ

ﻦﻴﻘﻘﺤﻣ داﺪﻌﺗ

) رﺎﻤﻴﺑ / ﺖﺳد ﭻﻣ ( ﻊﻄﻘﻣ ﺢﻄﺳ رﺎﻴﻌﻣ

) ﻲﻠﻴﻣ ﻊﺑﺮﻣﺮﺘﻣ ( ﺖﻴﺳﺎﺴﺣ

ﻲﮔﮋﻳو

نارﺎﻜﻤﻫ و ﺎﻳرﺎﺳ )

30 ( 40

/ 64 ﻞﻧﻮﺗ يدورو ﻊﻄﻘﻣ ﺢﻄﺳ

11<

73

57

نارﺎﻜﻤﻫ و نﺎﻜﻧود )

32 ( 68

9<

82

97

نارﺎﻜﻤﻫ و ﮓﻧو )

28 ( 35

<

9,8 89

83

نارﺎﻜﻤﻫ و ﻲﻟ )

31 ( 16

<

15 88

96

ﺎﻧﺎﺒﻴﭼﺎﺗ و ﻲﭽﻴﻣﺎﻛﺎﻧ )

32 ( 275

/ 414 ﻞﻧﻮﺗ ﻞﻛ ﻊﻄﻘﻣ ﺢﻄﺳ

<

12 67

97

نارﺎﻜﻤﻫ و گاﺪﻠﻴﺴﻳ )

19 ( 86

<

10,5 89

94

نارﺎﻜﻤﻫ و ﺮﻠﻳﻮﺴﻳز )

33 ( 77

9<

86

70

نارﺎﻜﻤﻫ و رزوﻼﻛ )

34 ( 68

<

10 100

- 94 95 - 57

نارﺎﻜﻤﻫ و ﻲﻟﺪﻧﻮﻣ )

35 ( 85

<

1 / 10 7

/ 64 -

و ﻮﺠﻧارﺎﻧ نارﺎﻜﻤﻫ ) 27 ( 68

<

7 / 9 6

/ 63 3 / 78

ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ 100

<

45 / 9 9

/ 78 8 / 82

و ندﻮﺑ سﺮﺘﺳد رد ،ندﻮﺑ ﺖﻤﻴﻗ نازرا ﻪﭼﺮﮔا ﻲﻤﺟﺎﻬﺗ ﺮﺘﻤﻛ ﻪﺑ ار وزاﺮﺗ ﻪﻔﻛ ﻲﻓاﺮﮔﻮﻧﻮﺳ ندﻮﺑ ﺮﺗ

ﻦﻴﮕﻨﺳ نآ زا هدﺎﻔﺘﺳا ﺖﻤﺳ ﻲﻟو ﺖﺳا هدﺮﻛ ﺮﺗ

ﺖﺴﻳژﻮﻟﻮﻳدار ترﺎﻬﻣ و ﻪﺑﺮﺠﺗ ﻪﺑ نآ دﺎﻳز ﻲﮕﺘﺴﺑاو ﻲﻄﻴﺤﻣ ﻂﻳاﺮﺷ و ﺺﺨﺸﻣ رﺎﻴﻌﻣ ﻚﻳ دﻮﺒﻧ و

ﺎﺗ هﺪﺷ ﺚﻋﺎﺑ ﻦﻴﻘﻘﺤﻣ ﻖﻓاﻮﺗ درﻮﻣ هﺪﺷ دراﺪﻧﺎﺘﺳا راﺪﻓﺮﻃﺮﭘ نﺎﻛﺎﻤﻛ ﻚﻴﺘﺳﻮﻨﮔﺎﻳدوﺮﺘﻜﻟا زا هدﺎﻔﺘﺳا ﺪﺷﺎﺑ

) 2 ، 8 و 15

ﻪﺑ يروﺮﻣ تﺎﻌﻟﺎﻄﻣ يدوﺪﻌﻣ ﻪﭼﺮﮔ.(

بذﺎﻛ ﻲﻔﻨﻣ

) ﺪﺻرد (

بذﺎﻛ ﺖﺒﺜﻣ

) ﺪﺻرد (

يرﺎﺒﺧا شزرا ﻲﻔﻨﻣ

) ﺪﺻرد (

يرﺎﺒﺧا شزرا ﺖﺒﺜﻣ

) ﺪﺻرد (

شﺮﺑ ﻪﻄﻘﻧ

) ﻲﻠﻴﻣ ﻊﺑﺮﻣ ﺮﺘﻣ (

يرﺎﻤﻴﺑ تﺪﺷ

15 5 61/5 91/8 9/45 ﻲﻠﻛ ﺖﻟﺎﺣ

6 5 91/9 80/8 12/2 ﺪﻳﺪﺷ و ﻂﺳﻮﺘﻣ

2 8 97/5 60 12/75 ﺪﻳﺪﺷ

(7)

49

ﻦﻳا رد تﺎﻌﻟﺎﻄﻣ ﻊﻴﻤﺟ ﻲﺳرﺮﺑ زا و ﻪﺘﺧادﺮﭘ ﻪﻄﺑار

رد ﻪﻌﻟﺎﻄﻣ مﺎﺠﻧا ﺖﻬﺟ ﺐﺳﺎﻨﻣ ﻲﻄﻴﺤﻣ ﻂﻳاﺮﺷ ﻲﺑﺎﻳزرا ﺖﻬﺟ ﺐﺳﺎﻨﻣ رﺎﻴﻌﻣ و ﻪﻨﻴﻣز ﻦﻳا هدﺮﻛ ﻪﺋارا ار ﻲﺗﺎﻔﻴﺻﻮﺗ ﻦﻳﺪﻣ ﺐﺼﻋ ﻚﻴﻓاﺮﮔﻮﻧﻮﺳ -

ﻲﻤﻧ هﺪﻳد ﺎﻬﻧآ رد ﻲﻧاﺪﻨﭼ ﺮﻈﻧ قﺎﻔﺗا ﻲﻟو ﺪﻧا دﻮﺷ

.

،ﻪﻌﻟﺎﻄﻣ ﻦﻳا رد هﺪﺷ ﻲﺳرﺮﺑ نارﺎﻤﻴﺑ داﺪﻌﺗ ﻪﭼ ﺮﮔا ﺐﺳﺎﻨﻣ تﺎﻌﻟﺎﻄﻣ ﺮﻳﺎﺳ ﻪﺑ ﺖﺒﺴﻧ ﻲﻣ ﺮﻈﻧ ﻪﺑ

ﺪﺳر

ﻪﻧﻮﻤﻧ مﺪﻋ ﻲﻟو ﺪﻫﺎﺷ هوﺮﮔ دﻮﺒﻧ و ﻲﻓدﺎﺼﺗ يﺮﻴﮔ

ﺖﻳدوﺪﺤﻣ زا ناﻮﺘﻴﻣ ار ﺖﺴﻧاد نآ يﺎﻫ

. ﺐﻠﻏا

لوﺪﺟ رد هﺪﺷ ﺮﻛذ تﺎﻌﻟﺎﻄﻣ 3

ﻢﻫ و ﻦﻳا ﻦﻴﻨﭼ

ﻪﻌﻟﺎﻄﻣ

، عﺎﺟرا مﻮﺳ ﺢﻄﺳ ﻲﻧﺎﻣرد ﺰﻛاﺮﻣ رد

(Tertiary health care) هﺪﺷ مﺎﺠﻧا

ﺖﺳا . ﻦﻳا

ﻢﻳﻼﻋ نارﺎﻤﻴﺑ ﻪﻛ ﺖﺳﺎﻨﻌﻣ ﻦﻳا ﻪﺑ ﻪﻠﺌﺴﻣ ﺢﺿاو

ﻪﺘﻓﺎﻳ و ﻪﺘﺷاد ياﺮﺑ ﻪﻛ ﺖﺳا ﻲﻧارﺎﻤﻴﺑ ﺮﺑ ﻖﺒﻄﻨﻣ ﺎﻫ

ﺖﻣﻼﻋ ﻲﻧﻻﻮﻃ ًﺎﺘﺒﺴﻧ ﻲﺗﺪﻣ هدﻮﺑ راد

ﺪﻧا . ﺮﻣا ﻦﻳا

ﻪﺘﻓﺎﻳ نداد ﻂﺴﺑ و ﻪﻌﻣﺎﺟ ﻞﻛ ﻪﺑ ﻪﻌﻟﺎﻄﻣ ﻦﻳا يﺎﻫ

ﻲﻓاﺮﮔﻮﻧﻮﺳ زا هدﺎﻔﺘﺳا ﺖﻬﺟ ﻲﺒﺳﺎﻨﻣ رﺎﻴﻌﻣ ﻦﺘﻓﺎﻳ لﺎﺑﺮﻏ ياﺮﺑ

ﻲﻣ دوﺪﺤﻣ ار يﺮﮔ مﺎﺠﻧا موﺰﻟ و دزﺎﺳ

ﻧﻮﻤﻧ ﺎﺑ ﻲﻨﻴﻟﺎﺑ ﻲﻳﺎﻣزآرﺎﻛ ﺮﺘﺸﻴﺑ ﻪﭼﺮﻫ ار ﻲﻓدﺎﺼﺗ ﻪ

ﮓﻧر ﺮﭘ ﻲﻣ ﺮﺗ ﺪﻨﻛ . ﻢﻫ ﺖﻬﺟ ﻲﺗآ تﺎﻌﻟﺎﻄﻣ ﻦﻴﻨﭼ

ﻪﻓﺮﺻ ﻪﺑ نوﺮﻘﻣ ﻲﺑﺎﻳزرا و ﻲﻓاﺮﮔﻮﻧﻮﺳ ندﻮﺑ

ﻚﻳ ﻦﺘﻓﺎﻳ ﺖﻬﺟ ﺮﺗﻻﺎﺑ ﺪﻫاﻮﺷ ﺢﻄﺳ ﺎﺑ تﺎﻌﻟﺎﻄﻣ ﻚﻴﻨﻴﻠﻛ رد اﺮﺟا ﻞﺑﺎﻗ ﻢﺘﻳرﻮﮕﻟا ﻪﺑ يروﺮﺿ ﺎﻫ

ﺮﻈﻧ

ﻲﻣ ﺪﺳر .

ﻪﺠﻴﺘﻧ يﺮﻴﮔ

ﻊﻄﻘﻣ ﺢﻄﺳ ﻲﺳرﺮﺑ ﻪﻛ داد نﺎﺸﻧ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ﺐﺼﻋ ﺺﻴﺨﺸﺗ رد لﺎﭘرﺎﻛ ﻞﻧﻮﺗ يدورو رد ﻦﻳﺪﻣ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ و هدﻮﺑ ﺪﻴﻔﻣ لﺎﭘرﺎﻛ ﻞﻧﻮﺗ مرﺪﻨﺳ ﻪﻧ ﻻﺎﺑ ﺖﺒﺜﻣ يرﺎﺒﺧا شزرا و ﻲﮔﮋﻳو ،ﺖﻴﺳﺎﺴﺣ رد ﻪﻜﻠﺑ كﻮﻜﺸﻣ نارﺎﻤﻴﺑ ﺺﻴﺨﺸﺗ رد ﺎﻬﻨﺗ ﻲﻣ ﺰﻴﻧ ﺮﻄﺧ ضﺮﻌﻣ رد ﻪﻌﻣﺎﺟ يﺮﮕﻟﺎﺑﺮﻏ ﺪﻧاﻮﺗ

ﺪﺷﺎﺑ ﺪﻨﻣدﻮﺳ .

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51 Comparison between Sonography and Electrodiagnostic Testing in the Diagnosis of Carpal Tunnel Syndrome

Amir‐reza Dalili¹, Mohsen Mardani‐kivi ^*2, Ahmad Alizadeh¹, Hamid‐reza Hatamian³, Mozaffar Hoseininejad³, Hamid Peyrazm⁴, Khashayar Saheb‐ekhtiari⁵, Keyvan Hashemi‐motlagh⁵

1. Radiologist, Radiology Department, Guilan University of Medical Sciences

2. Orthopedic Surgeon, Orthopedics Department, Guilan University of Medical Sciences

3. Neurologist, Neurology Department, Guilan University of Medical Sciences

4. Resident of Radiology,Guilan University of Medical Sciences 5. General Practitioner

_________________________________________________

Abstract

Background: Progress in high-contrast ultrasound technology in recent years brought more attention to its rule in the diagnosis of carpal tunnel syndrome (CTS). The aim of this study is to evaluate the diagnostic value of sonography in the diagnosis of CTS and its relationship with disease severity.

Methods: In this prospective study, 100 patients who had unilateral upper extremity involvement were studied. All patients were initially undergone electro diagnostic test and the test was assumed as the gold standard. Afterwards the cross-sectional area and anteroposterior diameter of the median nerve in the carpal tunnel inlet and outlet and the thickness of the flexor retinaculum were measured by ultrasound in all patients. Relationships between ultrasound and electro diagnostic findings were evaluated using SPSS software ver. 19^th.

Results: Patients included 84 women and 16 men in the age range 19 to 72 years (mean age 44.43 ± 12.05 years). Among the criteria evaluated, the proximal and distal cross sectional area of the nerve showed significant correlation with disease diagnosis (P= 0.018 and P= 0.022 respectively). In addition, significant relationship was found between mentioned two criteria and the severity of the disease (P<0.05 both). The best cut-off point at the proximal cross sectional area was 9.45 mm² in which the sensitivity was 78.9%, specificity was 82.8%, positive predictive value was 91.8% and negative predictive value was 61.5%.

Conclusion: The present study indicated that evaluating the cross sectional area of the median nerve using ultrasound at the carpal tunnel inlet is useful in diagnosing CTS. According to its high sensitivity, specificity and positive predictive value, it is not only useful in diagnosing suspected patients but also can be useful in screening the population at risk.

Key Words: Carpal Tunnel Syndrome, ultrasonography, electrodiagnosis

_______________________________________________________________________

*Corresponding Author: Dr Mohsen Marda‐kivi, Department of orthopedics, Poursina Hospital,Guilan University of Medical Sciences, Rasht,Guilan,Iran.

E‐mail: [email protected]

Anesthesiology and Pain

Official Journal of ISRAPM Autumn 2011, Vol2, No 5