摘要
目的对比研究内窥镜视下腕管松解术(endoscopic carpal tunnel release,ECTR)与常规腕管切开术(open carpal tunnel release,OCTR)治疗腕管综合征的临床疗效。方法对44例腕管综合征的患者,根据手术不同分为两组:ECTR组14例,OCTR组30例。观察术后患手创面愈合、瘢痕生长情况,"柱状"痛并发症的发生率,恢复工作时间和电生理检测等情况。结果术后随访时间为8～24个月,平均15.5个月。两组患者均未出现伤口感染及肌腱、神经、血管损伤等并发症。术后半年两组夜间疼痛症状全部消失,ECTR组和OCTR组手指麻木消失率分别为93.75%和91.18%,拇短展肌萎缩恢复率分别为57.14%和58.82%;"柱状"痛发生率分别为0%和23.53%,满意率分别为93.75%和67.65%,两组差异有统计学意义(P<0.05);术后1、3、6、12个月握力恢复率,ECTR组较OCTR组明显提高,差异有统计学意义(P<0.05);正中神经电生理检测两组差异无统计学意义。ECTR组在手术时间、恢复工作和住院时间均较OCTR组缩短。结论术后ECTR组在切口愈合较常规切开者美观、无"柱状"痛、握力恢复、缩短手术时间、平均住院日及恢复工作时间等方面优于OCTR组。
Objective To compare the results of endoscopic surgical decompression of carpal tunnel release （ECRT） with open carpal tunnel release （OCTR） and evaluate the superiority of ECTR in the treatment of carpal tunel syndrome （CTS）. Methods To Analysis the clinical data of 44 cases of carpal tunnel syndrome that were treated in two groups according to the differences of the operation mode, ECTR group （ n = 14） and OCTR group（ n = 30） .All cases were followed-up for an average period 15.5 months. To observe the condition of incision healing and variation of scar growth, the incidence rate of postoperative pillarpain, the satisfaction rate of six months postoperatively and the time needed to resume normal, lifestyle after operation. Restoration of the median nerve function was evaluated by measuring the grip strength , media nerve compound muscle action potential（CMAP） and sensory nerve action potential（SNAP） in 1 month, 3 months, 6 months and 12 months respectivel. Results All cases were followed-up without the complications of incision infection, ulceration and tendon, nerve or vascular injuries. The 6-menths follow-up data manifest that the symptoms of hypnalgia were both disappeared completely. The disappearance rate of numbness of the ECTR group and OCTR group was 93.75% and 91.18% respectively, and the muscular atrophy recovery rate of abductor pollicis brevis muscle was 57.14% and 58.82% respectively. The differences between two groups were of no statistical significance （ P 〉 0.05）. The 6-menths follow-up data manifest that the incidence rate of piUarpain of the ECTR group and OCTR group was 0% and 23.53% respectively, and the 6 months postoperatively satisfaction rate was 93.75% and 67.65% respectively. There were statistically significant differences between two groups （ P 〈 0.05）. The differences of the gripping power recovery rate of 1 month, 3 months, 6 months and 12 months postoperatively between the two groups were of statistical significance （ P 〈 0.01 ）. The differences of recovery rate of latent periods of CMAP of the median nerve on 1 month, 3 months, 6 months and 12 months postoperatively between the two groups were of no statistical significance （ P 〉 0.05）. The The time to return to work, operation time and hospitalization time of the ECTR group were all shorter than those of OCTR group and the differences were of statistic significance （ P 〈 0.05）. Conclusion Average length of stay and average time needed to return to work of ECTR group are shorter than those of OCTR group. Thus, the recovery of ECTR group is quicker than that of OCTR group.
出处
《中华手外科杂志》
CSCD
北大核心
2007年第2期74-76,共3页
Chinese Journal of Hand Surgery
基金
温州市科委课题基金y2004A069
关键词
腕管综合征
外科手术
内窥镜
外科手术
治疗结果
Carpal tunnel syndrome
Surgical procedures, endoscopes
Surgical procedures, operative
Treatment outcome
