术中高频超声在不同程度腕管综合征松解手术中的应用  

The application of intraoperative high-resolution ultrasonography in carpal tunnel syndrome with various degrees of severity

作　　者：张莉[1] 艾尔肯·热合木吐拉[1] 贾潇天 彭峰[1] 杨剑云[1] 蔡佩琴[1] 虞聪[1] 陈琳[1] 

机构地区：[1]复旦大学附属华山医院手外科卫生部手功能重建重点实验室上海市周围神经外科重点实验室,上海200040

出　　处：《中华手外科杂志》2015年第3期203-205,共3页Chinese Journal of Hand Surgery

基　　金：卫生部国家临床重点专科建设项目（2010）;上海市周围神经显微外科重点实验室课题项目（08DZ2270600）

摘　　要：目的 探讨术中高频超声在不同程度腕管综合征松解手术治疗中的临床意义.方法 对38例不同程度腕管综合征（CTS）患者术中进行高频超声检测,观察腕管内正中神经形态在术前及术中的变化,测量各断面正中神经的横截面积（CSA）及前后径.结果 术中高频超声观察到术前超声显示的正中神经受压位点在行神经松解术后消失.对中度CTS患者,正中神经厚度比（TR）在术前与术中的差异有统计学意义（P=0.002）.对重度患者,CSA-O及TR在术前与术中的差异均有统计学意义（P值分别为0.032、0.002）.结论 运用高频超声可判断术中正中神经受压部位是否解除.对于中重度CTS患者,术中高频超声测量的TR可用于对正中神经松解效果的评价.Objective To explore the clinical value of intraoperative high-resolution ultrasonography during surgical decompression of carpal tunnel syndromes （CTS） with varying degrees of severity.Methods Thirty-eight patients with different degrees of CTS underwent ultrasonography （US） of the wrist preoperatively and during carpal tunnel release.The shape of the median nerve in the carpal tunnel and the cross-sectional area （CSA） and anteroposterior diameter of the nerve before the surgery and immediately after carpal tunnel release during the surgery were compared.Results Intraoperative high-resolution ultrasonography revealed that the compression site of the median nerve identified by the preoperative ultrasonography disappeared after carpal tunnel decompression.For moderate CTS,median nerve thickness ratio （TR） was significantly different between preoperative US measurement and intraoperative measurement （P =0.002）.For severe CTS,CSA and TR showed significant differences between preoperative and intraoperative measurements （P =0.032 and 0.002,respectively）.Conclusion Intraoperative high-resolution ultrasonography may be considered as a complementary tool to observe the complete or incomplete release of median nerve compression site.For moderate and severe carpal tunnel syndrome,TR can be used to evaluate the effect of intraoperative median nerve decompression.

关 键 词：腕管综合征 超声检查 高频 

分 类 号：R544.1[医药卫生—心血管疾病]