卡压松解术治疗神经卡压综合征合并糖尿病患者的疗效分析  

Efficacies of neurolysis treatment on peripheral nerve entrapment syndrome in patients with diabetes mellitus

作　　者：胡锐[1] 廖苏平[1] 危蕾[1] 吴波[1] 刘俊[1] 王威[1] 陈振兵[2] 

机构地区：[1]华中科技大学同济医学院附属普爱医院骨科,汉市430033 [2]华中科技大学同济医学院附属协和医院手外科,武汉市430033

出　　处：《实用医学杂志》2013年第2期208-210,共3页The Journal of Practical Medicine

基　　金：国家自然科学基金资助项目(编号:30872627);卫生部手功能重建重点实验室;上海市周围神经显微外科重点实验室课题(编号:08DZ2270600)

摘　　要：目的:研究神经卡压松解术治疗上肢周围神经卡压综合征合并2型糖尿病患者的疗效。方法:回顾性研究2001年1月至2011年1月10年间我院手外科神经卡压松解手术治疗腕管综合征、肘管综合征、桡管综合征等上肢周围神经卡压综合征的病例485例(年龄40～90岁),确定合并有2型糖尿病病例的数量和比例,将其分为合并2型糖尿病和不合并2型糖尿病两组,采用中华医学会手外科学会上肢周围神经功能评定试用标准对术前及术后神经功能进行评分。结果:神经卡压综合征合并2型糖尿病的比例为18.4%(89/485),是否合并糖尿病组间比较结果为:合并2型糖尿病亚组术前神经功能评分4.68±0.93,不合并2型糖尿病亚组术前神经功能评分4.31±0.69(t=0.703,P=0.483),差异无统计学意义;合并2型糖尿病亚组术后神经功能评分9.32±0.89,不合并2型糖尿病亚组术后神经功能评分12.96±0.78(t=3.105,P=0.001),差异有统计学意义。结论:合并2型糖尿病的神经卡压综合征患者手术疗效明显较低,表明其神经症状同时与糖尿病周围神经病变有较大关系。Objective To investigate the effects of neurolysis treatment on peripheral nerve entrapment syndrome in patients with diabetes mellitus. Methods Data of 485 patients with carpal tunnel syndrome, cubital tunnel syndrome, radial tunnel syndrome, or other upper extremity peripheral nerve entrapment syndrome （aged 40 90 years） from hand surgery department of orthopaedic hospital of Wuhan from January 2001 to December 2010 were retrospectively studied, and were divided into 2 groups according to the combination of type 2 diabetes mellitus （Group A with diabetes, Group B without diabetes）. The preoperative and postoperative neurologic score were assessed by the Chinese Medical Association Society of hand Surgery trial standard. Results The incidence of type 2 diabetes mellitus in patients with peripheral nerve entrapment syndrome was 18.4% （89/485）. The preoperative neurological function score were 4.68± 0.93 and 4.31 ± 0.69 in Group A and Group B, respectively （t = 0.703, P = 0.483）; the postoperative neurological function score were 9.32 ± 0.89 and 12.96 ± 0.78 in Group A and Group B, respectively （t = 3.105, P = 0.001 ）. Conclusion The efficacies of surgery treatment for upper extremity peripheral nerve entrapment syndrome in patients with type 2 diabetes mellitus were lower, which indicated that the symptoms of peripheral nerve entrapment syndrome were related to diabetic peripheral neuropathy.

关 键 词：神经卡压综合征 2型糖尿病 神经松解术 回顾性分析 

分 类 号：R688[医药卫生—骨科学] R587.1[医药卫生—外科学]