| 李舒琳,邓小兵,徐雷.痛风石致腕管综合征的手术治疗.骨科,2022,13(1): 4-7. |
| 痛风石致腕管综合征的手术治疗 |
| Surgical Treatment of Carpal Tunnel Syndrome Caused by Tophaceous Gout |
| 投稿时间：2021-06-05 |
| DOI：10.3969/j.issn.1674-8573.2022.01.002 |
| 中文关键词: 痛风石 腕管综合征 手术 |
| 英文关键词: Tophaceous gout Carpal tunnel syndrome Surgery |
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| 中文摘要: |
| 目的 探讨痛风石导致腕管综合征的临床特点及手术治疗效果。方法 回顾性分析2017年10月至2019年12月于复旦大学附属华山医院手外科接受手术治疗的16例（17侧）痛风石致腕管综合征病人的临床资料，痛风病程（7.68±5.48）年，腕管综合征病程（5.22±2.24）个月。术中7侧可见正中神经局部压痕，9侧痛风石广泛包裹屈肌腱。观察比较手术前后的患指屈伸功能及正中神经远端运动潜伏期（distal motor latency，DML）；采用中华医学会手外科学会上肢部分功能评定试用标准评估患指功能恢复情况。结果 患侧伤口均一期愈合，术后随访（27.6±7.8）个月，术后患指屈伸功能和DML均较术前明显改善。按照中华医学会手外科学会上肢部分功能评定试用标准评定：优15侧，良2侧。结论 痛风石所致腕管综合征病人经内科治疗的基础上采用手术治疗能获得满意的临床效果，改善手指屈伸功能，提高病人的生活质量。 |
| 英文摘要: |
| Objective To evaluate the clinical characteristics and treatments of carpal tunnel syndrome caused by tophaceous gout. Methods A total of 16 cases (17 sides) of carpal tunnel syndrome caused by tophaceous gout who underwent surgical treatment in the Department of Hand Surgery of Huashan Hospital from October 2017 to December 2019 were studied retrospectively. The course of gout and carpal tunnel syndrome was (7.68±5.48) years and (5.22±2.24) months respectively. During the operation, local indentation of the median nerve was seen on 7 sides and the flexor tendons were widely wrapped by gout on 9 sides. The flexion and extension functions of the finger and distal motor latency (DML) were observed and compared. The evaluation criteria of upper extremity function issued by the Hand Surgery Society of Chinese Medical Association were used to evaluate the function of the finger. Results All the incisions achieved primary healing. All the patients were follow-up for (27.6±7.8) months postoperatively. The flexion and extension functions of the affected finger and DML were significantly improved after the operation. The hand function was evaluated as excellent on 15 sides and good on 2 sides according to the evaluation criteria of upper extremity function issued by the Hand Surgery Society of Chinese Medical Association. Conclusion Patients with carpal tunnel syndrome caused by tophaceous gout can obtain satisfactory clinical results with surgical treatment based on medical treatment. The surgical treatment can improve the flexion and extension of the fingers and the quality of life. |
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