手腕部结核性腱鞘滑膜炎致腕管综合征诊治经验  

Diagnosis and treatment experence of carpal tunnel syndrome caused by tuberculous tenosynovitis of the wrist

作　　者：胡时源 刘阳[1] 王爽[1] 徐永丽 刘志刚[1] HU Shiyuan;LIU Yang;WANG Shuang(Department of Hand and Foot Surgery, The First Hospital of Jilin University,Changchun, Jilin, 130021, China)

机构地区：[1]吉林大学第一医院手足外科

出　　处：《实用手外科杂志》2019年第2期150-152,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨因结核性腱鞘滑膜炎所致腕管综合征的临床表现及综合治疗效果。方法 2014年4月-2018年3月,对3例术前不能明确病因的腕管综合征患者行手术治疗,广泛切除腱鞘滑膜病变组织,经病检确诊为滑膜结核,术后行抗结核治疗,通过随访观察来评估疗效及总结经验。结果 3例患者术后1周内症状均有所改善,1个月后麻木症状消失。其中1例术后5个月可疑为结核性腱鞘滑膜炎复发,虽未出现患手感觉异常,但对掌功能较前受限。结论结核性腱鞘滑膜炎可导致腕管综合征,手术治疗效果明显,并且术后应进行规范的抗结核治疗,否则容易复发。Objective To explore the clinical manifestations and comphrehensive treatment effect of carpal tunnel syndrome caused by tuberculous tenosynovitis. Methods Three patients with carpal tunnel syndrome whose causes could not be determined preoperatively were treated by extensive surgical resection of affected tendon sheath and synovial membranes. Tuberculous tenosynovitis was diagnosed by pathological examination. Postoperatively, anti-tuberculosis therapy was carried out. The efficacy was evaluated and the experience was summarized through follow-up. Results All 3 patients showed improved symptoms within 1 week after surgery, and numbness disappeared 1 month later. Among them,1 patient presented suspected recurrent tuberculous tenosynovitis in the 5th month after surgery, with limited palmar function but no paresthesia. Conclusion Tuberculous tenosynovitis may lead to carpal tunnel syndrome. The efficacy of surgery is obvious, and postoperative regular anti-tuberculosis therapy should be conducted, otherwise recurrence will be likely to occur.

关 键 词：结核 滑膜炎 腕管综合征 

分 类 号：R688[医药卫生—骨科学] R529.0[医药卫生—外科学]