摘要
目的观察应用自制组合式带槽透明扩张管在内窥镜下切断腕横韧带,治疗腕管综合征的疗效。方法 2003年4月-2008年4月,采用自制组合式带槽透明扩张管,在内窥镜下对腕横韧带进行松解治疗腕管综合征56例。男8例,女48例;年龄38～65岁,平均50岁。其中有腕部外伤史5例,前臂骨折12例,长期手工劳动者39例。均为单侧;左侧14例,右侧42例。病程2～7年,平均4年。临床症状按照滨田分级方法分级,Ⅰ级38例,Ⅱ级12例,Ⅲ级6例。结果术后切口均Ⅰ期愈合。患者均获随访,随访时间14～68个月,平均40个月。术后6个月关节功能按照Kelly等分级方法,获优25例,良22例,一般4例,差5例,优良率为83.93%。术后1、3、6、12个月正中神经远端运动电位潜伏期为(4.48±0.50)、(4.06±0.35)、(3.79±0.25)、(3.42±0.24)ms,与术前(5.09±0.61)ms比较,差异均有统计学意义(P<0.05);术后各时间点间比较,差异均有统计学意义(P<0.05)。结论应用组合式带槽透明扩张管在内窥镜下能对腕横韧带精确切割、充分松解,释放腕管压力,是一种治疗腕管综合征简便、有效的手术方法。
Objective To study the effect of surgical treatment of carpal tunnel syndrome （CTS） by endoscope through a transparent combined with dilation conductor to cut the transverse carpal ligament. Methods Between April 2003 and April 2008, 56 patients with CTS were treated with endoscopic carpal tunnel release through a transparent combined with dilation conductor. There were 8 males and 48 females with an average age of 50 years （range, 38-65 years）. CTS was caused by wrist injury in 5 cases, by forearm fracture in 12 cases, and by wrist strain in 39 cases. The locations were left hand in 14 cases and right hand in 42 cases with a disease duration range of 2-7 years （4 years on average）. According to Hamada classification of CTS, 38 cases were classified as stage I, 12 cases as stage II, and 6 cases as stage III. Results All cases achieved the primary healing of incision. All patients were followed up 14-68 months （40 months on average）. According to Kelly’s evaluation, the results were excellent in 25 cases, good in 22 cases, fair in 4 cases, and poor in 5 cases with an excellent and good rate of 83.93%. The distal motor latency of median nerve was （4.48 ± 0.50） ms at 1 months, （4.06 ± 0.35） ms at 3 months, （3.79 ± 0.25） ms at 6 months, and （3.42 ± 0.24） ms at 12 months after operation, showing significant differences when compared with the preoperative one [（5.09 ± 0.61） ms, P〈0.05]. There were significant differences among different time points after operation （P〈0.05）. Conclusion The method of endoscope through a transparent combined with dilation conductor to cut the transverse carpal ligament is a simple and effective surgical procedure for treament of CTS, which can precisely cut the transverse carpal ligament and completely release the pressure of carpal tunnel.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2010年第9期1066-1068,共3页
Chinese Journal of Reparative and Reconstructive Surgery
基金
四川省卫生厅基金资助项目(030142)~~
关键词
组合式带槽透明扩张管
腕管综合征
内窥镜
腕管松解术
Transparent combined with dilation conductor Carpal tunnel syndrome Endoscope Carpal tunnel release
