合并颈神经根压迫的腕管综合征临床疗效分析  

Analysis of clinical outcomes of carpal tunnel syndrome combined with cervical nerve root compression

作　　者：田敏涛[1] 白露[2] 邵森垚[2,3] 王天兵[2] 姜保国[2] 

机构地区：[1]宁波市第六医院手外科,宁波315040 [2]北京大学人民医院创伤骨科,北京100044 [3]北京大学医学部

出　　处：《北京大学学报（医学版）》2012年第6期838-841,共4页Journal of Peking University:Health Sciences

基　　金：北京市科技支撑;市政府重点工作项目(Z101107052210001)资助~~

摘　　要：目的:通过对合并颈神经根压迫的腕管综合征(carpal tunnel syndrome,CTS)临床疗效分析,对比其与单纯腕管综合征在临床表现、诊疗效果中的不同。方法:2004年2月至2010年10月北京大学人民医院创伤骨科以腕管综合征为主要诊断共收治患者93例(120侧),男性21人,女性72人。其中合并颈神经根压迫患者共29例,明确诊断后93例患者全部行周围神经松解术,术后平均随访16个月。结果:术后症状、体征改善的程度按BMRC(British Medical Research Council)分级标准进行评定,分为优、良、差3级。29例患者影像学检查可见颈神经根压迫,其术后功能为优者达86.21%,为良者达13.79%;其余64例无神经根压迫患者,术后功能为优者90.63%,为良者9.37%。结论:合并颈神经根压迫患者行周围神经松解术有效,但其完全缓解率较无合并者低;周围神经松解手术能部分减轻或改善颈神经根压迫症状;男性合并颈神经根压迫患者比率明显高于女性,因此对该类患者在诊断及治疗上要注意是否存在双卡综合征的可能。Objective：To analyze the clinical curative effect of carpal tunnel syndrome（CTS） combined with cervical nerve root compression and to explore the differences between CTS combined with cervical nerve root compression and simple CTS in the clinical manifestations,diagnosis and treatment.Methods：From February 2004 to October 2010,93 cases（120 sides） were selected among the patients（21 males and 72 females） adopted to our department and primarily diagnosed as CTS,of whom 29 had cervical nerve root compression.Neurolysis of peripheral nerve was conducted in the 93 cases,and the mean follow-up period was 16 months.Results：The results of the improvements of symptoms and signs after operation were evaluated by the British Medical Research Council（BMRC）.According to the BMRC scores,we divided the patients into three stages：excellent,good and none.In the 93 patients,29 were with visible nerve root compression in radiograph or magnetic resonance imaging,in whom the excellent rate was 86.21%,and the good rate 13.79%,meanwhile in the patients without nerve root compression,the excellent rate was 90.63% and the good rate 9.37%.Conclusion：In the case of CTS combined with cervical nerve root compression,our findings are as follows：Firstly,neurolysis of peripheral nerve has an accurate curative effect;Secondly,neurolysis of peripheral nerve may decline the symptoms of nerve root compression;Thirdly,patients with nerve root compression are obviously more common in men,therefore,we should pay attention to the double crash when it comes to the male patient.

关 键 词：腕管综合征 神经根病 神经卡压综合征 治疗结果 

分 类 号：R681.7[医药卫生—骨科学]