内镜下松解术联合屈肌腱滑膜切除治疗腕管综合征的疗效观察  

Clinical observation of endoscopic carpal tunnel release combined with flexor tendon synovium resection in the treatment of carpal tunnel syndrome

作　　者：刘胜元 韦正知 黄建民 马建军 LIU Sheng-yuan;WEI Zheng-zhi;HUANG Jian-min(Department of Orthopedics,Guangxi Hospital of Liugang,Liuzhou Guangxi 545002,China)

机构地区：[1]广西柳钢医疗有限公司医院骨科,广西柳州545002

出　　处：《临床和实验医学杂志》2022年第10期1081-1085,共5页Journal of Clinical and Experimental Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z20190438)。

摘　　要：目的探讨内镜下松解术联合屈肌腱滑膜切除治疗腕管综合征的疗效。方法回顾性选取2020年2月至2021年6月广西柳钢医疗有限公司医院骨科收治的80例腕管综合征患者,按不同手术方式分为两组:对照组34例,研究组46例。对照组实施内镜下松解术,研究组在松解术基础上联合屈肌腱滑膜切除治疗。比较两组术后疗效、握力与捏力、上肢功能评定量表(DASH)与上肢功能指数量表(UEFI)评分、拇短展肌肌肉复合动作电位与中环指感觉神经动作电位潜伏期、波幅。结果研究组有效率为100.00%,高于对照组(91.18%),差异有统计学意义(P<0.05)。治疗后,两组患者的握力、捏力均较治疗前显著升高,研究组患者的握力、捏力为(24.89±1.40)、(8.75±1.29)kg,显著高于对照组[(22.14±1.41)kg、(7.64±1.12)kg],差异均有统计学意义(P<0.05)。两组DASH评分较治疗前显著降低,UEFI评分较治疗前提升,研究组患者的DASH评分为(12.36±3.34)分,低于对照组[(16.54±5.13)分],UEFI评分为(74.68±2.65)分,高于对照组[(71.40±3.12)分],差异均有统计学意义(P<0.05)。治疗后,两组拇短展肌肌肉复合动作电位潜伏期较治疗前下降,其波幅与中环指感觉神经动作电位潜伏期、波幅均较治疗前上升,且研究组拇短展肌肌肉复合动作电位潜伏期为(3.84±0.23)ms,低于对照组[(4.26±0.38)ms],其波幅与中环指感觉神经动作电位潜伏期、波幅为(6.33±1.84)mV、(8.33±0.65)ms、(6.15±0.69)mV,均高于对照组[(5.24±0.71)mV、(5.66±0.75)ms、(5.24±0.71)mV],差异均有统计学意义(P<0.05)。结论内镜下松解术联合屈肌腱滑膜切除治疗方式能显著改善腕管综合征患者症状,提高疗效,对腕关节功能恢复具有促进作用。Objective To discuss the clinical efficacy of endoscopic carpal tunnel release combined with flexor tendon synovium resection in the treatment of carpal tunnel syndrome.Methods Eighty patients with carpal tunnel syndrome in Department of Orthopedics,Guangxi Hospital of Liugang from February 2020 to June 2021 were enrolled,and classified into two groups according to different surgical methods.Control group(n=34)received endoscopic carpal tunnel release,while study group(n=46)received endoscopic carpal tunnel release combined with flexor tendon synovium resection.Then various indexes were compared between two groups,including postoperative outcomes,grip strength and pinch strength,Disability of the Arm,Shoulder and Hand(DASH),Upper Extremity Functional Index(UEFI),latency and the amplitude of compound muscle action potential(CMAP)of abductor pollicis and sensory nerve action potential(SNAP)of middle ring fingers.Results The overall efficacy rate was 100.00%in study group,which was significantly higher than in control group(91.18%),with statistical difference(P<0.05).After treatment,the grip strength and pinch strength in the two groups were significantly higher than those before treatment,the grip strength and pinch strength in the study group were(24.89±1.40)kg,(8.75±1.29)kg,which were significantly higher than those in the control group[(22.14±1.41)kg,(7.64±1.12)kg],and the differences were statistically significant significance(P<0.05).The DASH scores of the two groups were significantly lower than those before treatment,and the UEFI scores were higher than those before treatment,the DASH scores in the study group were(12.36±3.34)points,which were lower than those in the control group[(16.54±5.13)points],and the UEFI scores were(74.68±2.65)points,which were higher than those in the control group[(71.40±3.12)points],the differences were statistically significant(P<0.05).After treatment,the latency of compound muscle action potential of abductor pollicis in the two groups decreased compared with before tre

关 键 词：腕管综合征 内镜下松解术 屈肌腱滑膜切除 腕功能 

分 类 号：R688[医药卫生—骨科学]