三种小切口腕管松解术治疗腕管综合征的对比研究  

A comparative study of carpal tunnel release through three kinds of small incision for the treatment of carpal tunnel syndrome

作　　者：王小龙[1] 韩超前[1] 温树正[1] 郝增涛[1] 赵建民[2] 殷超[1] 樊东升[1] 景尚斐[1] 王永飞[1] 王继宏[1] 刘瑞[2] Wang Xiaolong;Han Chaoqian;Wen Shuzheng;Hao Zengtao;Zhao Jianmin;Yin Chao;Fan Dongsheng;Jing Shangfei;Wang Yongfei;Wang Jihong;Liu Rui(Department of Hand and Foot Microsurgery,the Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010030,China;Department of Orthopedics,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学第二附属医院手足显微外科,呼和浩特市010030 [2]内蒙古医科大学附属医院骨科,呼和浩特市010050

出　　处：《中华手外科杂志》2020年第2期106-110,共5页Chinese Journal of Hand Surgery

摘　　要：目的对比腕掌侧横行小切口、纵行小切口和手掌根部纵行小切口三种手术入路治疗腕管综合征的临床疗效以及并发症。方法自2015年6月至2018年6月我们共诊治150例腕管综合征患者,手术采用腕掌侧横切口50例、腕掌侧纵切口50例、掌根部纵切口50例,均进行腕管松解术。于术后1、3、6个月比较三组患者的视觉模拟评分(visual analogue scale,VAS)、BCTQ评分、Kelly评定法评价的临床疗效、术后并发症发生情况、神经电生理参数、两点分辨觉以及手术基本情况。结果三组患者术后1、3、6个月VAS、BCTQ评分以及Kelly评定法评价的临床疗效有效率和优良率相比差异无统计学意义(P>0.05);腕掌侧纵切口组患者的术后瘢痕痛和整体并发症发生率明显高于腕掌侧横切口组、掌根部纵切口组,差异有统计学意义(P<0.05)。三组患者的切口长度、住院费用、手术时间、住院时间、恢复工作时间、两点分辨觉、各项神经电生理参数相比差异均无统计学意义(P>0.05)。结论三种小切口腕管松解术治疗腕管综合征整体疗效相似,但掌根部纵行小切口和腕掌侧横行小切口腕管松解术并发症更少。Objective To compare the clinical efficacy and complications of small transverse and longitudinal incision of the wrist,and the small longitudinal incision of the palm in the treatment of carpal tunnel syndrome(CTS).Methods From June 2015 to June 2018,150 patients with CTS were diagnosed and treated.There were 50 cases of wrist small transverse incision,50 cases of wrist small longitudinal incision and 50 cases of longitudinal incision at the root of the palm for carpal tunnel release.The visual analogue scale(VAS),BCTQ score,Kelly's evaluation of clinical efficacy,postoperative complications,neuro-electrophysiological parameters,two-point discrimination and basic operation conditions were compared in three groups at 1,3 and 6 months after operation.Results There was no significant difference in VAS,BCTQ score and Kelly's evaluation of clinical efficacy and excellent rate between the three groups(P>0.05);the incidence of postoperative scar pain and overall complications in the wrist longitudinal incision group was significantly higher than that in the wrist transverse incision group and the longitudinal incision at the root of the palm(P<0.05).There was no significant difference in incision length,hospitalization cost,operation time,hospitalization time,recovery working time,two-point discrimination and various neuro-electrophysiological parameters among the three groups(P>0.05).Conclusion The results of three kinds of small incision carpal tunnel release surgery are similar in the treatment of CTS,but the complications of longitudinal incision at the root of the palm and wrist small transverse incision for carpal tunnel release surgery are less.

关 键 词：腕管综合征 治疗结果 小切口 松解 

分 类 号：R6[医药卫生—外科学]