慢性滑膜炎所致腕管综合征的手术治疗  

Surgical treatment of carpal tunnel syndrome caused by chronic synovitis

作　　者：李振宇 薛存银[1] 贾照强[1] 王桂龙 伏传升[1] 魏宝富[1] Li Zhenyu;Xue Cunyin;Jia Zhaoqiang;Wang Guilong;Fu Chuansheng;Wei Baofiu(Department of Hand Surgery,Linyi People's Hospital,Linyi 276000,China)

机构地区：[1]临沂市人民医院手外科,临沂276000

出　　处：《中华手外科杂志》2023年第5期451-454,共4页Chinese Journal of Hand Surgery

摘　　要：目的探讨手术治疗慢性滑膜炎所致腕管综合征的临床疗效。方法我院自2022年2月至10月手术治疗7例慢性滑膜炎所致腕管综合征, 术中广泛切除滑膜病灶组织, 彻底松解腕横韧带, 切除标本送病理、细菌培养及分子生物学检测, 术后予消肿、止痛、营养神经等对症治疗, 依据术后症状改善、滑膜炎是否复发、疼痛改善情况评估临床疗效。结果病理结果均示滑膜组织增生、炎性细胞浸润, 术后1例证实结核性滑膜炎予抗结核治疗, 术后随访6~14个月, 正中神经卡压症状明显改善, 滑膜炎无复发, 局部无疼痛, 手指屈伸活动可。结论手术治疗慢性滑膜炎所致腕管综合征疗效满意, 术中广泛切除滑膜病灶组织, 松解正中神经是预防复发和确保临床疗效的关键。Objective To explore the clinical efficacy of surgical treatment of carpal tunnel syndrome(CTS)caused by chronic synovitis.Methods From February to October 2022,our hospital underwent surgical treatment for 7 cases of carpal tunnel syndrome caused by chronic synovitis.During the surgery,the synovial lesion tissue was extensively removed,the transverse carpal ligament was completely released,and the excised specimens were sent for pathological,bacterial culture,and molecular biology testing.After the surgery,symptomatic treatments such as swelling reduction,pain relief,and nutrition were given.The clinicalfficacy was evaluated based on the improvement of postoperative symptoms,whether synovitis recurred,and the improvement of pain.Results The pathological results showed synovial tissue hyperplasia and inflammatory cell infiltration.One case was confirmed astuberculous synovitis after surgery and received anti-tuberculosis treatment.The postoperative follow-up ranged from 6 to 14 months showed significant improvement in median nerve compression symptoms,no recurrence of synovitis,no local pain,and normal finger flexion and extension.Conclusions The surgical treatment for carpal tunnel syndrome caused by chronic synovitis has a satisfactory effect.The extensive resection of synovial lesion tissue and release of the median nerve during surgery are key to preventing recurrence and ensuring clinical efficacy.

关 键 词：滑膜炎 腕管综合征 正中神经松解 

分 类 号：R687.3[医药卫生—骨科学]