改良小切口手术治疗中重度迟发性正中神经麻痹CTS的临床疗效观察  

作　　者：孙坚钧 楼永锋 陈丽青[2] 郭雷光 

机构地区：[1]浙江省浦江县中医院,322200 [2]浙江省浦江县人民医院,322200

出　　处：《浙江临床医学》2024年第2期224-226,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨分析改良小切口手术松解与传统腕掌部开放手术在治疗中、重度迟发性正中神经麻痹腕管综合征(CTS)的临床疗效观察。方法通过回顾性分析的研究方法,选取2020年1月至2021年2月收治的17例迟发性正中神经麻痹CTS患者作为对照组(传统腕掌部开放手术),选取2021年3月至2022年8月收治的23例迟发性正中神经麻痹CTS患者作为观察组(改良小切口手术松解)进行回顾性临床研究分析。结果两组在一般资料比较上差异无统计学意义(P>0.05),具有可比性。观察组在术后6个月后两点辨别觉距离、疼痛评分、Levine评分、DASH量表评分均优于对照组(P<0.05)。两组术后6个月时肌电图指标CMAP、SNAP、SCV结果较术前均明显升高(P<0.05),且观察组升高幅度优于对照组(P<0.05),两组术后的有效率上,观察组比对照组更具优效性(P<0.05),且观察组的手术时间与对照组相比明显缩短;两组术后腕部柱状痛发生率比较分析,观察组更具优效性(P<0.05),有效率高于对照组。结论与传统腕掌部开放手术治疗中重度迟发性正中神经麻痹CTS比较,改良小切口松解术不仅可以提高临床疗效降低术后并发症,提高临床有效率,还具有优化手术指标、改善正中神经电生理功能、减小腕关节功能损伤等优势。Objective To investigate and analyze the clinical efficacy of modified small incision surgery and traditional carpal volar open surgery in the treatment of moderate to severe delayed median nerve palsy carpal tunnel syndrome(CTS).Methods By retrospective analysis,17 patients with delayed median nerve palsy CTS admitted from January 2020 to February 2021 were selected as the control group(traditional carpal volar open surgery).Twenty-three patients with delayed median nerve palsy CTS admitted from March 2021 to August 2022 were selected as the observation group(modified small-incision surgical release)for retrospective clinical study analysis.Results There was no significant difference in general data between the two groups(P>0.05).The observation group was superior to the control group in two-point discerning distance,pain score,Levine score and DASH score 6 months after operation(P<0.05).At 6 months after operation,the results of postoperative electromyogram(EMG)indicators CMAP,SNAP and SCV in both groups were significantly higher than those before operation(P<0.05),and the increase range in the observation group was better than that in the control group(P<0.05).In terms of postoperative efficiency,the observation group was more effective than the control group(P<0.05).The operation time of the observation group was significantly shorter than that of the control group.The incidence of postoperative column pain in the wrist was compared between the two groups.The observation group was more effective(P<0.05),and the effective rate was higher than the control group.Conclusion Compared with traditional carpomarpal open surgery in the treatment of moderate-to-severe delayed median nerve palsy carpal tunnel syndrome,modified small-incision release can not only improve clinical efficacy,reduce postoperative complications,improve clinical efficiency,but also optimize surgical indicators,improve median nerve electrophysiological function,and reduce wrist joint functional injury.

关 键 词：腕管综合征 改良小切口松解术 腕横韧带 回顾性研究 临床疗效观察 

分 类 号：R688[医药卫生—骨科学]