3D打印精准定位指导尺神经沟成形治疗肘管综合征  

3D printing precise positioning guided ulnar groove plasty for treatment of cubital tunnel syndrome

作　　者：董汉青 吴兴 许朋成 王晴雯 张植生[1] 赵建勇[1] Dong Hanqing;Wu Xing;Xu Pengcheng;Wang Qingwen;Zhang Zhisheng;Zhao Jianyong(Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou 061001,Hebei Province,China)

机构地区：[1]沧州市中西医结合医院,河北省沧州市061001

出　　处：《中国组织工程研究》2024年第18期2825-2829,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:随着肘管综合征患者增多,尺神经沟成形术不影响尺神经的正常解剖结构及走行,是治疗肘管综合征的主要外科手术之一。3D打印结合尺神经沟成形可以更精准地定位神经沟的拓展深度及宽度,从而避免一些手术并发症。目的:探讨3D打印技术结合尺神经沟成形对肘管综合征患者神经电生理及预后的影响。方法:选择2020年3月至2022年3月就诊于沧州市中西医结合医院的70例中重度肘管综合征患者作为研究对象,随机分为2组,每组35例,对照组行传统尺神经沟成形术,观察组行3D打印技术结合尺神经沟成形术,随访3个月。比较两组患者的临床疗效优良率,患肢拇短展肌复合肌肉动作电位潜伏期、波幅及尺神经运动传导速度,患侧握力、示中指和拇示指捏力、小指S-W单丝触觉、小指两点分辨觉及上肢功能障碍评定量表评分。结果与结论:①与对照组(74%)比较,观察组的疗效优良率(91%)显著升高(P<0.05);②与治疗前比较,治疗后两组患肢拇短展肌复合肌肉动作电位潜伏期显著缩短,波幅及尺神经运动传导速度显著升高;观察组潜伏期显著短于对照组,波幅及尺神经运动传导速度显著高于对照组(P<0.05);③与治疗前比较,治疗后两组患侧握力、示中指和拇示指捏力显著增大,小指S-W单丝触觉、小指两点分辨觉显著降低;观察组患侧握力、示中指和拇示指捏力显著大于对照组,小指S-W单丝触觉、小指两点分辨觉显著小于对照组(P<0.05);④与治疗前比较,治疗后两组上肢功能障碍评定量表评分显著降低,观察组显著低于对照组(P<0.05);⑤提示3D打印技术结合尺神经沟成形治疗肘管综合征,能够有效提高患者的临床疗效,促进其神经电生理恢复,改善手指和上肢功能,具有较高的临床应用价值。BACKGROUND:With the increase of patients with cubital tunnel syndrome,ulnar groove plasty does not affect the normal anatomical structure and distribution of the ulnar nerve,which is one of the main surgical procedures for the treatment of cubital tunnel syndrome.3D printing combined with ulnar groove plasty can more accurately position the expansion depth and width of the ulnar groove to avoid some surgical complications.OBJECTIVE:To investigate the effect of 3D printing technology combined with ulnar groove plasty on nerve electrophysiology and prognosis in patients with cubital tunnel syndrome.METHODS:A total of 70 patients with moderate and severe cubital tunnel syndrome who were treated in Cangzhou Integrated Traditional Chinese and Western Medicine Hospital from March 2020 to March 2022 were selected as the study subjects.They were divided into two groups,with 35 cases in each group.The control group underwent traditional ulnar groove plasty.The observation group underwent 3D printing technology combined with ulnar groove plasty.The patients were followed up for 3 months.The clinical efficacy,latency,amplitude of compound muscle action potential of abductor pollicis brevis of the affected limb and ulnar nerve motor conduction velocity,grip strength on the affected side,pinch strength of the middle and thumb fingers,S-W monofilament of the little finger,two-point discrimination of the little finger,and Disabilities of the Arm,Shoulder and Hand Questionnaire score were compared between the two groups.RESULTS AND CONCLUSION:(1)Compared with the control group(74%),the excellent and good rate was significantly higher in the observation group(91%)(P<0.05).(2)Compared with pre-treatment,the latency of compound muscle action potential of abductor pollicis brevis of affected limb was significantly shorter and the wave amplitude and ulnar nerve motor conduction velocity were significantly higher in the two groups after treatment.The latency was significantly shorter and the wave amplitude and ulnar nerve motor conduc

关 键 词：3D打印技术 尺神经沟成形 肘管综合征 神经电生理 预后 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R338.8