超声引导单通道内镜下松解腕横韧带治疗腕管综合征应用分析  

Ultrasound-guided single-channel endoscopic release of the transverse carpal ligament for carpal tunnel syndrome

作　　者：梁原浩 张翼翔 彭盛昕 肖文珊 刘垒 LIANG Yuanhao;ZHANG Yixiang;PENG Shengxin;XIAO Wenshan;LIU Lei(College of Traditional Chinese Medicine,Shandong Second Medical University,Weifang 261053,China;College of Rehabilitation Medicine,Binzhou Medical University,Binzhou 256603,China;College of Rehabilitation Medicine,Shandong First Medical University,Jinan 250000,China;Department of Pain treatment,The First Affiliated Hospital of Shandong First Medical University,Jinan 250014,China)

机构地区：[1]山东第二医科大学中医学院,山东潍坊261053 [2]滨州医学院康复医学院,山东滨州256603 [3]山东第一医科大学康复医学院,山东济南250000 [4]山东第一医科大学第一附属医院疼痛科,山东济南250014

出　　处：《医学影像学杂志》2024年第3期90-93,共4页Journal of Medical Imaging

基　　金：齐鲁卫生与健康领军人才培育工程项目(编号:鲁卫人才字[2020]3号);山东第一医科大学校级教育教学改革研究课题项目(编号:2021XY085);第一批山东省体卫融合示范项目(编号:鲁体办字[2024]2号)。

摘　　要：目的探讨超声引导单通道内镜下腕横韧带松解技术治疗腕管综合征(CTS)的效果。方法选取收治的CTS患者32例,正中神经经肌骨超声定位,局部麻醉后通过单通道内镜下松解腕横韧带。术前、术后1天肌骨超声扫描正中神经横截面积(CSA)及扁平率;波士顿腕管问卷评估术后7天、30天、90天的腕部症状与功能;Kelly分级于术后90天评定临床疗效。结果术后1天患者正中神经卡压状态缓解。术后各时间节点波士顿腕管问卷症状与功能评分均较术前降低,差异均有统计学意义(均P<0.05)。Kelly分级临床疗效评价优良率为96.9%。结论超声引导单通道内镜下松解腕横韧带治疗CTS疗效肯定,值得临床推广。Objective To observe the effect of ultrasound-guided single channel endoscopic release of transverse carpal tun‐nel ligament in the treatment of carpal tunnel syndrome(CTS).Methods Thirty-two patients with CTS admitted to the pain de‐partment of our hospital from December 2021 to January 2023 were collected.Median nerve was located by musculoskeletal ultra‐sonography.After local anesthesia,the transverse wrist was released by single channel endoscope.Median nerve cross-sectional area(CSA)and flat rate were scanned by musculoskeletal ultrasonography before and 1 day after surgery;The Boston carpal tun‐nel questionnaire was used to evaluate wrist symptoms and function at 7,30 and 90 days after surgery.Kelly grading was per‐formed 90 days after surgery to evaluate clinical efficacy.Results The rates of median nerve CSA at the level of pea bone and median nerve flat at the level of uncinate bone were lower than those before surgery 1 day after surgery,with statistical signifi‐cance(all P<0.05).The symptoms and functional scores of the Boston carpal tunnel questionnaire were lower than the preopera‐tive scores,with statistical significance(all P<0.05).The excellent and good rate of Kelly grade 90 days after surgery was 96.9%.Conclusion Ultrasound-guided single channel endoscopic release of the transverse carpal ligament in the treatment of CTS is effective and worthy of clinical promotion.

关 键 词：腕管综合征 超声检查 椎间孔镜 

分 类 号：R686[医药卫生—骨科学] R445.1[医药卫生—外科学]