摘要
目的观察超声引导下的环线切割手术治疗腕管综合征的近远期疗效。方法前瞻性纳入2012年12月至2016年12月收治的90例腕管综合征患者为对象,按照随机数表法分为两组,各45例。其中对照组行切开减压手术,观察组基于超声引导下行环线切割手术。对比两组术后疗效、手术基本情况,采用波士顿腕管综合征评分量表(BCTQ)评估神经功能恢复状态,并观察术后不良反应及随访结果。结果观察组优良率为88.89%,对照组优良率为82.22%,差异无统计学意义(P>0.05);观察组手术时间、住院时间、术后返回工作时间显著短于对照组(P<0.05),术中出血量显著低于对照组(P<0.05),但术后正中神经长宽比、肿胀比较对照组差异无统计学意义(P>0.05);两组术前BCTQ评分比较差异无统计学意义(P>0.05),术后1~12个月BCTQ评分均明显下降,显著低于术前(P<0.05),但观察组术后各时点BCTQ评分较对照组差异无统计学意义(P>0.05);两组术后均未出现感染、血管损伤、神经损伤、伤口愈合不良等情况,随访1年发现两组疼痛性瘢痕、墩柱部疼痛发生率比较差异无统计学意义(P>0.05)。结论与切开减压手术相比较,超声引导下的环线切割手术治疗腕管综合征近远期疗效明显,微创优势显著。
Objective To observe the near and long term effect of ultrasonic guided circumcision in the treatment of carpal tunnel syndrome. Methods 90 cases of carpal tunnel syndrome patients from December 2012 to December 2016 in our hospital were enrolled in this study as the objects,and were randomly divided into two groups,45 cases in each group. The control group underwent incision and decompression surgery,the observation group based on ultrasound guided circumcision. The postoperative curative effect and the basic operation condition were compared. The Boston wrist syndrome score scale（ BCTQ） was used to evaluate the recovery state of neurological function,and the postoperative adverse reactions and follow-up results were observed. Results The excellent rate of the observation group was 88. 89%,and the control group 82. 22%,and the difference was not statistically significant（ P〈0. 05）; The operative time,hospitalization time and postoperative return time in the observation group were significantly shorter than those in the control group（ P〈0. 05）,and the intraoperative blood loss was significantly lower than that in the control group（ P〈0. 05）. However,there was no significant difference in the length to width ratio and swelling between median nerve and the control group after operation（ P〈0. 05）. There was no significant difference in the BCTQ score between the two groups before operation（ P〈0. 05）. The BCTQ score decreased significantly at 1 - 12 months after operation,which was significantly lower than that before operation（ P〈0. 05）,but there was no statistically significant difference in the BCTQ score of the observation group at all time points after operation（ P〈0. 05）. No infection,vascular injury,nerve injury and wound healing occurred in the two groups after operation. After 1 years of follow-up,there was no significant difference in pain incidence between two groups（ P〈0. 05）. Conclusion The ultrasonic guided circumcision in the treatment of carpal tunnel syndrome is obvious in the near and long term,and the advantage of minimally invasive is significant.
作者
徐斌
吴楠
符常河
唐彬
XU Bin;WU Nan;FU Chang-he(Hand and Foot Surgery,The People＇s Liberation Army 463 Hospital,Shenyang Liaoning 110042,China.)
出处
《临床和实验医学杂志》
2018年第15期1657-1660,共4页
Journal of Clinical and Experimental Medicine
关键词
腕管综合征
超声
环线切割手术
Carpal tunnel syndrome
Ultrasound
Circumcision
