| 张玉军,张广亮,赵强,等.系统诊断并有限小切口减压治疗中重度腕管综合征.骨科,2022,13(1): 12-15. |
| 系统诊断并有限小切口减压治疗中重度腕管综合征 |
| Systematic Diagnosis and Limited Small Incision Decompression for Moderate and Severe Carpal Tunnel Syndrome |
| 投稿时间：2021-04-15 |
| DOI：10.3969/j.issn.1674-8573.2022.01.004 |
| 中文关键词: 腕管综合征 系统 诊断 外科手术 |
| 英文关键词: Carpal tunnel syndrome Systematic Diagnosis Surgery |
| 基金项目:苏州市科技计划项目（SYSD2018052） |
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| 中文摘要: |
| 目的 探讨经系统诊断并有限小切口切开减压治疗中重度腕管综合征的临床疗效。方法 前瞻性地纳入2015年1月至2020年1月于我院就诊的腕管综合征病人，均结合症状、体格检查、肌电图、B超等检查系统诊断为中度或重度腕管综合征，分别纳入中度组（30例）和重度组（30例）。采用有限小切口切开减压治疗。随访时采用顾玉东腕管综合征功能评定标准综合判断手术治疗效果。结果 本组病人切口均一期愈合。60例病人均获得随访，时间为3~24个月，平均8个月。通过体格检查，中度组手术后关节功能较术前有明显好转，重度组多数较术前好转，少数恢复欠佳。根据顾玉东腕管综合征功能评定标准：中度组，优22例，良8例；重度组，优8例，良12例，可9例，差1例；两组术后功能评分均明显优于术前，差异有统计学意义（P＜0.05）。结论 腕管综合征经过系统诊断可以明确损伤程度和手术指征，采用有限小切口切开松解治疗，创伤小、恢复佳、疗效确切、效果满意，是中重度腕管综合征的有效治疗方法。 |
| 英文摘要: |
| Objective To investigate the clinical efficacy of the treatment of systematic diagnosis of moderate and severe carpal tunnel syndrome by limited small incision decompression therapy. Methods The patients with carpal tunnel syndrome treated in our hospital from January 2015 to January 2020 were prospectively included. They were diagnosed as moderate or severe carpal tunnel syndrome with symptoms, physical examination, electromyography and B-ultrasound. They were included in the moderate group (30 cases) and the severe group (30 cases) respectively. Limited small incision was used for decompression. During the follow-up period, Gu Yudong's functional assessment standard for carpal tunnel syndrome was used to comprehensively judge the effect of surgical treatment. Results Primary healing was achieved in all the incisions. The patients were follow-up for 3-24 months with an average of 8 months. Through physical examination, the joint function of patients in the moderate group was improved significantly after operation, and that of most patients in the severe group was improved significantly after operation, but a few patients did not obtain satisfactory recovery. According to Gu Yudong's functional assessment standard for carpal tunnel syndrome, there were 22 cases of excellent effectiveness and 8 cases of good effectiveness in the moderate group; in severe group, effectiveness was excellent in 8 cases, good in 12 cases, fair in 9 cases, and poor in 1 case. Postoperative score was significantly better than preoperative score, and the difference between preoperative and postoperative scores was statistically significant (P＜0.05). Conclusion Systematic diagnosis of carpal tunnel syndrome can precisely judge the classification and surgical indications. It is an effective method for the treatment of moderate and severe carpal tunnel syndrome with small incision. The small incision has the advantages of small trauma, quick recovery, definite curative effect and satisfactory effect. |
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