正中神经主干联合返支松解治疗中重度腕管综合征的临床效果  

Clinical Effect of Median Nerve Trunk Combined With Return Branch Release in the Treatment of Moderate-to-Severe Carpal Tunnel Syndrome

作　　者：刘子文 刘文辉 韩海[1] 李良华[1] 王清玉[1] LIU Ziwen;LIU Wenhui;HAN Hai;LI Lianghua;WANG Qingyu(Department of Orthopedics and Traumatology,the People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou Fujian 350000,China)

机构地区：[1]福建中医药大学附属人民医院骨伤科,福建福州350000

出　　处：《中国卫生标准管理》2024年第16期80-84,共5页China Health Standard Management

基　　金：福建中医药大学校管临床专项课题(XB2022118)。

摘　　要：目的探讨正中神经主干松解联合返支探查松解术治疗腕管综合征的临床效果。方法选取2022年7月—2023年10月福建中医药大学附属人民医院诊断为中重度腕管综合征患者35例42侧,采用改良传统切口行正中神经主干松解同时对正中神经返支进行探查松解,对返支压迫及易形成卡压的因素彻底松解,术后定期随访。主要观察手术前后运动电位潜伏期和感觉神经传导速度变化及正中神经功能评分改变。结果所有患者均获随访。术后8周肌电图运动电位潜伏期和感觉神经传导速度分别为(3.96±1.03)ms、(44.84±3.00)m/s,优于术前的(8.47±1.61)ms、(32.98±2.09)m/s,差异有统计学意义(P<0.05);术后8周正中神经评分的优良率优于术前,差异有统计学意义(P<0.05)。结论中重度腕管综合征患者中,正中神经返支大多存在压迫或较多易卡因素,行腕管综合征切开减压手术时,不应拘泥于手术切口大小,应予以彻底松解以提高临床疗效。Objective To explore the clinical effECT of median nerve trunk release combined with return branch exploratory release in the treatment of carpal tunnel syndrome.Methods A total of 35 cases and 42 sides of patients in the People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine diagnosed with moderate-to-severe carpal tunnel syndrome were admitted from July 2022 to October 2023,and a modified traditional incision was used to release the main trunk of the median nerve and at the same time,the return branch of the median nerve was also explored and released,and the compression of the return branch and the factors that are prone to form a compression were completely loosened,and the patients were followed up regularly after the operation.Changes in motor potential latency and sensory nerve conduction velocity and changes in median nerve function score were mainly observed before and after surgery.Results The latency of EMG motor potential and sensory nerve conduction velocity at 8 weeks after operation were(3.96±1.03)ms and(44.84±3.00)m/s,respectively,which were better than(8.47±1.61)ms and(32.98±2.09)m/s before operation,the difference was statistically significant(P<0.05).The good rate of median nerve score at 8 weeks after operation was better than that before operation,and the difference was statistically significant(P<0.05).Conclusion In patients with moderate-to-severe carpal tunnel syndrome,the return branch of the median nerve often has compression or more easy cardinal factors,when performing incisional decompression surgery for carpal tunnel syndrome,we should not be confined to the size of the surgical incision,and it should be completely loosened in order to improve the clinical efficacy.

关 键 词：腕管综合征 正中神经 正中神经返支 松解术 正中神经双卡征 临床研究 

分 类 号：R615[医药卫生—外科学]