腕管综合征术后正中神经形态变化研究分析  

Analysis of Postoperative Morphological Changes of Medium Nerve in Carpal Tunnel Syndrome

作　　者：左贵松 申才良[1] 潘宏[2] 丁腾云[2] 杨擎[2] 

机构地区：[1]安徽医科大学第一附属医院,合肥230032 [2]安徽医科大学附属安庆医院,安庆246003

出　　处：《基因组学与应用生物学》2017年第1期23-29,共7页Genomics and Applied Biology

基　　金：安徽省自然科学基金(1508085MH152)资助

摘　　要：目前缺乏腕管综合征术后正中神经形态变化的定量研究,以及形态变化指标对术后评估的作用。本研究通过观察腕管综合征正中神经术前术后形态学改变情况,并探讨正中神经形态学变化指标与早期疗效的相关性。应用高频超声和磁共振测量46例腕管综合征正中神经术前及术后腕管入口(豌豆骨平面)、腕管出口(钩骨钩平面)的横截面积及横截面的横径和前后径,计算出术前术后正中神经在腕管入出口的肿胀率和扁平率,以及术前术后横截面积、肿胀率和扁平率的变化值。术后3个月对其早期疗效进行评分,并将术前术后正中神经的形态学变化指标与术后早期疗效进行相关性分析。高频超声检查正中神经术后入口区横截面积较术前减小(0.196±0.155)%,肿胀率减小(0.211±0.131)%;腕管出口区正中神经横截面积较术前减小(0.086±0.241)%,肿胀率减小(0.733±0.096)%,扁平率减小(0.122±0.082)%。磁共振检查正中神经术前术后入口区横截面积较术前减小(0.142±0.190)%,肿胀率减小(0.233±0.285)%;腕管出口区正中神经横截面积较术前减小(0.087±0.256)%,肿胀率减小(0.052±0.271)%,扁平率减小(0.760±0.544)%。两种检查数据均显示出腕管松解术后正中神经形态有显著变化,腕管入口区横截面积及肿胀率变化与术后早期疗效有显著相关性,可作为术后早期疗效的预测指标。There has been lack of quantitative study on the morphological changes of the medium nerve after OCTR and the effect of morphological changes on postoperative evaluation. In this research, we observed the morphological changes of the median nerve in carpal tunnel syndrome before-and-after OCTR to analyze the statistic correlation between these data and the early postoperative performance in CTS patients. Ultrasonic and MR were used to measure the cross-sectional areas and the transverse and anteroposterior diameter of cross sections of carpal tunnel inlet （pisiform bone plane） and outlet （hamulus ofhamate bone plane） of the medium nerve before-and-after OCTR of 46 CTS patients, and we calculated the swelling and flattening rate of the median nerve on inlet and outlet sections of the carpal tunnel as well as the change values of cross-sectional area, swelling rate and flattening rate before and after operation. The early treatment outcomes were evaluated 3 months after operation, which was correlatedly analyzed with the morphological changes of the medium nerve. The result of high-frequency ultrasound showed that postoperative cross-sectional area at the inlet plane of the medium nerve reduced （0.196±0.155）%, and the swelling rate reduced （0.211 ±0.131）%. The postoperative cross-sectional area at the outlet plane of the medium nerve reduced （0.086±0.24 1）%, the swelling rate reduced （0.733±0.096）%, and the flattening rate reduced （0.122±0.082）%. MRI data showed nerve cross-sectional area at inlet plane of the medium nerve reduced （0.142±0.190）% and the swelling rate reduced （0.233±0.285）% after surgery; the cross-sectional area at the outlet plane reduced （0.087±0.256）%, the swelling rate reduced （0.052±0.271）%, and the flattening rate reduced （0.760±0.544）%. The above two results both showed that there were statistically significant differences in inlet and outlet plane of the medium nerve before and after operation. The cross-sectional area and swelling r

关 键 词：腕管综合征 术后 正中神经形态 超声及磁共振 

分 类 号：R688[医药卫生—骨科学]