Wide-awake结合肌骨超声下腕管综合征针刀手术治疗的临床观察  

Application of Wide-awake Combined with Musculoskeletal Ultrasonography in Needle-knife Operation of Carpal Tunnel Syndrome

作　　者：盛华荣 饶泉 严朝浪 刘佳[1] 杨凤云[1] SHENG Hua-rong;RAO Quan;YAN Zhao-ang;LIU Jia;YANG Feng-yun(The Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330006,China)

机构地区：[1]江西中医药大学附属医院,南昌330006

出　　处：《江西中医药大学学报》2023年第5期32-34,共3页Journal of Jiangxi University of Chinese Medicine

基　　金：江西省中医药科研计划项目(2019A172)。

摘　　要：目的:观察局麻无止血带技术(wide-awake)结合肌骨超声在腕管综合征(CTS)针刀手术中的应用效果。方法:选取江西中医药大学附属医院2019年7月—2021年5月收治的CTS患者52例,随机数字表法分为观察组(n=26)和对照组(n=26),观察组使用wide-awake结合肌骨超声CTS针刀手术治疗,对照组采用传统针刀手术治疗。比较2组视觉模拟评分(VAS)、出血量、Levine腕管综合征问卷评分、肌电图指标和疗效,记录不良事件。结果:术前、术中和术后观察组患者VAS评分和术中出血量均显著低于对照组(P<0.05);术后2组Levine腕管综合征问卷功能和症状评分均明显降低(P<0.05),且观察组显著低于对照组(P<0.05);2组术后肌电图指标有显著改善(P<0.05),且观察组明显优于对照组(P<0.05);观察组疗效优于对照组(P<0.05);观察组未见不良事件,对照组不良事件1例。结论:wide-awake结合肌骨超声疗法疗效显著,可有效降低CTS针刀手术时患者的疼痛感和出血量,改善临床症状且安全性可靠。Objective:To observe the application of wide-awake local anesthesia no tourniquet(wide-awake)combined with musculoskeletal ultrasonography in needle-knife operation of carpal tunnel syndrome(CTS).Methods:A total of 52 patients with CTS admitted to the Affiliated Hospital of Jiangxi University of Chinese Medicine were selected between July 2019 and May 2021.They were divided into observation group(n=26)and control group(n=26)by random number table method.Patients in the observation group were treated with wide-awake combined with musculoskeletal ultrasonography assisted needle-knife operation,while patients in the control group were treated with traditional needle-knife operation.The Visual Analogue Scale(VAS)scores,blood loss,Levine carpal tunnel syndrome questionnaire scores,electromyography parameters and overall curative effect were compared between the two groups.Adverse events were recorded.Results:The VAS scores during and after operation,and intraoperative blood loss of observation group were significantly lower/less than those of the control group(P<0.05).After operation,the function and symptom scores in the Levine carpal tunnel syndrome questionnaire were significantly reduced,and the observation group had significantly lower scores than the control group(P<0.05).After operation,electromyography parameters in the two groups were significantly improved,and these parameters in observation group were significantly better than those in the control group(P<0.05).The total response rates in the observation group is better than control group(P<0.05).There were no adverse events in the observation group and 1 in the control group.Conclusion:The application of wide-awake combined with musculoskeletal ultrasonography in needle-knife operation of CTS showed significant efficacy,which can effectively reduce pain and blood loss during CTS acupotomy surgery,improve clinical symptoms and is safe and reliable.

关 键 词：局麻无止血带技术 肌骨超声 腕管综合征 针刀治疗 

分 类 号：R246.2[医药卫生—针灸推拿学]