事件记录
Dr. 米勒: 肌电图. 这比你想象的要简单. We're going to talk about that next on Scope Radio.
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Dr. 米勒: 我是博士. 汤姆·米勒和我. 丹尼尔Cushman. He's a sports medicine physician who uses electromyelography, or 肌电图. And, Dan, it's easier than people might think it is. I think there's some news out there from the past experiences of folks who say that it's painful. You hear about this on blogs and websites that you read. And I think that some patients come in and they're very nervous about having this procedure because they think it's pretty onerous, 从他们所读到的. 谈谈这个. 现在情况大不一样了.
Dr. Cushman: 肯定. I think this is one thing that I do where every day, 当有人进来, I have to talk them down before we even get started.
Dr. 米勒: 真的? 因为他们在网上查过了?
Dr. Cushman: They hear from their friends is the most common thing. Their friend will say, "Oh, I had this done to me. 这是有史以来最糟糕的事情."
Dr. 米勒: And they're usually talking about an experience that was some time ago?
Dr. Cushman: 正确的. 完全.
Dr. 米勒: 肌电图是什么? Let's talk about that first and then go into how you do it and why it's less painful or stressful?
Dr. Cushman: So 肌电图 talks about electromyography, which is looking at the electrical signals from the muscle. And the point of that is really to examine how well the muscles are working, 神经的工作情况如何, 它们会进入肌肉. 这个测试有两个部分. One is called the nerve conduction study. And what happens there is a small probe is placed on the nerve, 在皮肤表面, and a small shock is sent down the nerve. Just like in a wire, we can see how well that nerve is working by sending a signal down it. 这是第一部分.
Dr. 米勒: 这听起来 . . . 你知道, when somebody hears they're going to get shocked, 他们显然认为, “啊哦, 这可能会非常不舒服."
Dr. Cushman: 完全. And so the way it works is that we just basically go up slowly on the electricity until they start even feeling it. They don't even feel it at the beginning. 然后他们得到 . . . usually, the first one is the worst one. 然后，他们就习惯了. It's kind of like when you rub your feet on carpeting, 你触碰金属, 没有人喜欢这种感觉. But if you were to do that to yourself four times, 第四次的时候, 你会说, "Oh, 我已经习惯了."
Dr. 米勒: 就像静电一样.
Dr. Cushman: 就是这样. 是的.
Dr. 米勒: So it's not like touching something coming out of a wall socket.
Dr. Cushman: 一点也不.
Dr. 米勒: 一点也不.
Dr. Cushman: No.
Dr. 米勒: 好吧. 现在，针头呢? 你偶尔会用针 . . .
Dr. Cushman: 完全.
Dr. 米勒: . . . 当你做肌电信号时.
Dr. Cushman: So the second part of the test is the actual 肌电图 portion. And that's using a small needle about the size of an acupuncture needle, so really thin. 大发娱乐所做的就是, 大发娱乐不用电, we just put it into different muscles along, 在身体里, 取决于测试. So when we put that needle into the muscle, we can hear how the nerves are talking to the muscle. This part, on average, the pain level for people is somewhere in the range 3 out of 10. 大多数人都会这么说. 不怎么疼. 更像是抽筋的感觉.
And when we do this, this gives us a lot of information. It can help us find if there's a pinched nerve, even though we're not really doing anything with the nerves. 大发娱乐只是在锻炼肌肉. 它可以告诉大发娱乐很多信息. 它可以告诉大发娱乐问题的时间, 如果有新的问题, 如果神经有损伤, 或者如果神经没有受损, and if things are getting better or have not started healing yet.
Dr. 米勒: Talk about some of the common conditions where you use 肌电图 to back up your clinical diagnosis.
Dr. Cushman: The most common that I do is probably carpal tunnel syndrome in the wrist. 这可能是最常见的. And then I would say the second most common would be a pinched nerve either in the neck or in the back.
Dr. 米勒: 基本上，如果你有 . . . I mean, most of your patients are probably referred. 是这样吗？?
Dr. Cushman: 是的，大多数都是.
Dr. 米勒: And so you're getting patients from their referring providers who think they might have the right diagnosis, but they come to you to back up that diagnosis.
Dr. Cushman: 这是正确的. A good example would be a hand surgeon who . . . somebody might come in and say, "My fingers hurt," or, "My wrist hurts," or, "My hand hurts." And the surgeon can't particularly tell if that's coming from a pinched nerve in the neck or a pinched nerve in the wrist. And so, this test would help differentiate those.
Dr. 米勒: So, 很明显, 并非所有患者都需要肌电图, but perhaps just a percentage of patients where the diagnosis is unclear.
Dr. Cushman: 正确的.
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