B超辅助定位小切口治疗肘管综合征的临床疗效分析  

Clinical efficacy analysis of small incision assisted by B-ultrasound localization in the treatment of cubital tunnel syndrome

作　　者：王天亮 王洋 顾加祥 张乃臣 Wang Tianliang;Wang Yang;Gu Jiaxiang;Zhang Naichen(Department of Hand and Foot Surgery,Clinical Medical college,Yangzhou University,Subei People′s Hospital of Jiangsu Province,Yangzhou 225009,China)

机构地区：[1]扬州大学临床医学院,江苏省苏北人民医院手足外科,扬州225009

出　　处：《中华手外科杂志》2023年第4期346-349,共4页Chinese Journal of Hand Surgery

摘　　要：目的探讨B超辅助定位小切口原位减压治疗肘管综合征的临床疗效。方法回顾分析自2019年11月至2022年6月于我科住院治疗,符合纳入与排除标准且在B超辅助下行小切口原位减压的16例病例,术前病程1~48个月,平均8个月,记录手术时间、术后止疼药物依赖情况、瘢痕情况(VSS评分)、术后改良的Bishop评分。结果术后16例患者均获得了良好的症状缓解,随访时间为3~18个月,平均11个月。手术时长为15~30 min,平均21 min。术后VAS评分2~4分,平均3分。术后VSS评分2~4分,平均3分。术后改良Bishop评分2~9分,平均7分。没有1例出现血肿、感染、松解不彻底等并发症。结论 B超辅助下原位减压松解肘部尺神经卡压,具有手术时间较短、疼痛小、瘢痕小、并发症少、症状缓解确切等优点,是一种可供选择的治疗肘管综合征的方式。Objective To explore the clinical efficacy of small incision assisted by B-ultrasound localization in the treatment of cubital tunnel syndrome.Methods A retrospective analysis was conducted on 16 patients who were hospitalized in our department from November 2019 to June 2022,met the inclusion and exclusion criteria,and underwent small incision in situ decompression with ultrasound assistance.The preoperative course of the disease was 1 to 48 months,with an average of 8 months.The surgical time,postoperative pain medication dependence,scar condition(VSS score),and postoperative modified Bishop score were recorded.Results All the 16 patients achieved good symptom relief after surgery,with a follow-up period of 3 to 18 months,with an average of 11 months.The surgical duration is 15 to 30 minutes,with an average of 21 minutes.The postoperative VAS score was 2 to 4 points,with an average of 3 points.The postoperative VSS score was 2 to 4 points,with an average of 3 points.The postoperative modified Bishop score was 2 to 9 points,with an average of 7 points.No complications such as hematoma,infection,and incomplete lysis occurred.Conclusion The application of decompression in situ assisted by B-ultrasound to relieve the entrapment of the ulnar nerve at the elbow has the advantages of shorter operation time,less pain,less scar,fewer complications,and accurate symptom relief.It is an alternative treatment for cubital tunnel syndrome.

关 键 词：肘管综合征 尺神经 B超定位 爪形手 小切口 

分 类 号：R687.3[医药卫生—骨科学]