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关节镜下腕管松解术治疗腕管综合征的临床疗效

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目的 探讨关节镜下腕管松解术治疗腕管综合征的临床疗效。方法 本研究为回顾性队列研究。我科自2020年1月至2023年1月收治腕管综合征患者143例,分为观察组和对照组,观察组采用关节镜下腕管松解术,对照组采用传统腕管松解术,术后对比两组的临床疗效。按照顾玉东推荐的腕管综合征功能评定标准,于术后1、3、6个月比较两组的示指末节两点分辨觉、肌电图检查结果(正中神经传导速度和感觉动作电位)、正中神经超声及波士顿腕管(BTCQ)评分,并用Kelly评定法评价临床疗效,用核磁共振检查比较两组患者术前及术后正中神经在豌豆骨平面的横截面积(CSA)、扁平率(MNFR)、正中神经肿胀率(MNSR)。结果 两组患者术后示指末节两点分辨觉、正中神经传导速度、感觉动作电位、正中神经超声、BTCQ评分、Kelly评分、CSA、MNFR、MNSR比较差异没有统计学意义。结论 两种手术方式治疗腕管综合征效果相似,但关节镜下腕管松解术较传统的手术方式切口小、操作简便、恢复更快。
Clinical efficacy of arthroscopic carpal tunnel release surgery for the treatment of carpal tunnel syndrome
Objective To investigate the clinical efficacy of arthroscopic carpal tunnel release for carpal tunnel syndrome.Methods This study is a retrospective cohort study.143 patients with carpal tunnel syndrome admitted from January 2020 to January 2023 were selected and divided into observation group and control group.The observation group underwent arthroscopic carpal tunnel release surgery,while the control group underwent traditional carpal tunnel release surgery.The clinical efficacy of the two groups was compared after surgery.According to the functional evaluation criteria for carpal tunnel syndrome recommended by Gu Yudong,the two-point discrimination of the distal segment of the index finger,electromyographic examination results(median nerve conduction velocity and sensory action potential),median nerve ultrasound,and Boston carpal tunnel(BTCQ)scores were compared between the two groups at 1,3,and 6 months after surgery,and the clinical efficacy was evaluated using the Kelly evaluation method.The cross-sectional area(CSA),flatness rate(MNFR),and median nerve swelling rate(MNSR)of the median nerve in the pea bone plane between two groups of patients before and after surgery were compared using magnetic resonance imaging.Results There was no statistically significant difference between the two groups of patients in terms of two-point discrimination of the distal segment of the index finger,median nerve conduction velocity,sensory action potential,median nerve ultrasound,BTCQ score,Kelly score,CSA,MNFR,and MNSR.Conclusion The two surgical methods have similar effects in treating carpal tunnel syndrome,but arthroscopic carpal tunnel release surgery has a smaller incision,simpler operation,and faster recovery compared to traditional surgical methods.

Carpal tunnel syndromeArthroscopesMagnetic resonance imaging

刘鹏飞、王培、孔宇、霍明艳、付世杰

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承德医学院附属医院手足外科,承德 067000

腕管综合征 关节镜 磁共振成像

承德市科技计划(2022)

202204A077

2024

中华手外科杂志
中华医学会

中华手外科杂志

CSTPCD北大核心
影响因子:1.258
ISSN:1005-054X
年,卷(期):2024.40(2)
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