摘要
目的介绍腕管综合征内窥镜手术（endoscopic carpal tunnel release，ECTR）预防正中神经损伤并发症的方法。方法利用彩色多普勒超声仪（B超）对37例74手患者术前进行检测。结果71例正中神经走行在桡侧腕屈肌腱与掌长肌腱之间，3例走行在掌长肌腱与尺侧腕屈肌腱之间，并术中确认。结论正中神经变异走行在掌长肌腱与尺侧腕屈肌腱之间是ECTR的禁忌证，B超能准确定位正中神经与掌长肌腱关系，避免内窥镜手术损伤正中神经，更具有简单、经济、方便可靠等优点。
Objective To introcluee a method of preventing median never injury during endoscopic carpal tunnel release （ECTR）. Methods Ultrasonography of both wrists was done to 37 patients of carpal tunnel syndrome who were going to undergo open release of the ~ansverse carpal ligament. Structures in the carpal tunnel were visualized to guide surgical decision-making. Results Ultrasonography showed that median never lies between the tendon of flexor carpi radialis and palmaris longus in 71 patients and lies between the tendon of palmaris longus and flexor carpi ulnaris in 3 patients. These findings were confirmed during the surgeries. Conclusion It is a contraindieation of ECTR if median never lies between palmaris longus and flexor carpi ulnaris. Ultrasonography can accurately reveal the relative position of median never to the palmaris longus tendon. Pre-operafive ultrasonography of the wrist is a simple, inexpensive and convenient method to exclude these eontraindicatious and thus orevent median never iniuries in ECTR.
出处
《中华手外科杂志》
CSCD
北大核心
2011年第1期35-38,共4页
Chinese Journal of Hand Surgery
基金
上海市周围神经显微外科重点实验室课题（08DE2270600）
关键词
腕管综合征
内窥镜
超声检查
手术后并发症
Carpal tunnel syndrome
Endoscopes
Ultrasonography
Postoperative complications
