腕部小切口腕横韧带完全切断与部分切断治疗重度腕管综合征的疗效对比
Comparison of clinical effects on the treatment of severe carpal tunnel syndrome with complete and partial amputation of transverse carpal ligament through small incision
张博闻 1贾怀续 2张巧霞 1黄永禄 1巩凡 1吴建科 1丁一 1马国续 1张梓炀 1赵飞1
作者信息
- 1. 宁夏回族自治区人民医院手足和重建显微外科,宁夏回族自治区银川 750002
- 2. 宝鸡市人民医院骨科,陕西宝鸡 721000
- 折叠
摘要
目的 通过整理腕部小切口行腕横韧带(transverse carpal ligament,TCL)完全切断与腕横韧带部分切断治疗腕管综合征(carpal tunnel syndrome,CTS)患者的相关临床资料,对比分析两种手术方式在治疗腕管综合征患者术后的临床疗效是否存在差异,为选择更佳的手术方式治疗腕管综合征提供参考.方法 选取2019年9月-2021年2月在本院手足外科接受腕部小切口行腕横韧带部分切断(观察组)与腕横韧带完全切断(对照组)治疗重度腕管综合征的患者.经严格的纳入标准筛查后,其中观察组15例,对照组17例.对术前及术后的腕管综合征功能评分、正中神经功能评分、握力改变等进行分析对比.数据分析采用SPSS 22.0统计学软件进行分析,探究两种手术方式治疗重度CTS的疗效是否存在差异性.结果 术后手术切口甲级愈合,无手术并发症发生.所有患者随访12个月,未出现柱状痛、弓弦状畸形等并发症.腕管综合征功能评分、正中神经功能评分,两组相比无统计学意义(P＞0.05).腕部握力测定,术后6个月内腕横韧带部分切断者较完全切断者握力更强,差异有明显的统计学意义(P＜0.05);术后6～12个月时两组握力强度数据统计提示两组之间差异无明显的统计学意义(P＞0.05).结论 两种方法治疗重度CTS可获得同等疗效.但腕部小切口部分切断腕横韧带较完整切断TCL比较,具有手术切口小,方法简便易行,效果切实可靠,不破坏握力解剖结构,术后功能恢复快的优点.
Abstract
Objective To compare and analyze the clinical data of patients with carpal tunnel syndrome(CTS)treated with complete and partial cut of the transverse carpal ligament through small incision at the wrist and evaluate whether there are differences in the clinical effects of two surgical methods in the treatment of patients with carpal tunnel syndrome,thereby to provide a reference for choosing a better surgical method in the treatment of carpal tunnel syndrome.Methods Patients with severe carpal tunnel syndrome were selected from September 2019 to February 2021 in the department of hand-foot surgery of our hospital who underwent partial cut of transverse carpal ligament(experimental group)and complete cut of transverse carpal ligament(control group).According to the inclusion criteria,General data of the patients were collected,15 patients in the experimental group and 17 patients in the control group.By analysis and comparison of preoperative and postoperative indicators of two groups,such as carpal tunnel syndrome function score,median nerve function score,grip strength.We explored whether there were differences between two surgical methods in the treatment of severe CTS.The data were analyzed by SPSS 22.0 statistical software.Results The incision healed with no complications.All patients were followed up for 12 months,and there were no complications such as columnar pain and bowstring deformity.Carpal tunnel syndrome function score and median nerve function score were not statistically significant between two groups(P＞0.05).The determination of wrist grip strength showed that the grip strength of partial amputation of transverse ligament was stronger than that of complete amputation within 6 months after surgery,and there was significant statistical difference(P＜0.05).There was no significant difference in grip strength between two groups from 6 to 12 months after operation(P＞0.05).Conclusion Compared with the complete cutting of TCL,the small incision of the transverse wrist ligament has the advantages of small incision,simple method,practical and reliable effect,no damage to the anatomical structure of grip strength,and fast recovery of postoperative function.Two methods can achieve the same efficacy in the treatment of severe CTS.
关键词
腕管综合征/腕横韧带/小切口/部分切断Key words
Carpal tunnel syndrome/Transverse carpal ligament/Small incision/Partial amputation引用本文复制引用
基金项目
自治区科技惠民项目(2023CMG03014)
宁夏回族自治区青年科技人才托举工程项目(2020-78)
宁夏回族自治区重点研发计划(2019BEG3044)
医院科技创新人才项目(2023)(2023-72)
出版年
2024
NETL
NSTL
万方数据