内窥镜下应用组合式带槽透明扩张管治疗腕管综合征  

TREATMENT OF CARPAL TUNNEL SYNDROME BY ENDOSCOPE THROUGH TRANSPARENT COMBINED WITH DILATION CONDUCTOR

作　　者：谭鸿[1] 陈曦[1] 谢德[1] 汪红[1] 方志[1] 

机构地区：[1]德阳市人民医院骨科,四川德阳618000

出　　处：《中国修复重建外科杂志》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)~~

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.

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 

分 类 号：R688[医药卫生—骨科学]