小切口尺神经原位松解治疗肘管综合征的效果观察  

Observation on the effect of small incision in situ release of ulnar nerve in the treatment of cubital tunnel syndrome

作　　者：邓智明 祝伟 缪玉龙 孙乾 梅远东 DENG Zhiming;ZHU Wei;MIAO Yulong(Department of Hand and Foot Surgery,Affiliated Changshu Hospital of Natong University,Changshu,Jiangsu,215500,China)

机构地区：[1]南通大学附属常熟医院手足外科,江苏常熟215500

出　　处：《实用手外科杂志》2024年第4期427-431,共5页Journal of Practical Hand Surgery

基　　金：苏州市2021年度第三十二批科技发展计划(项目编号:SKJY2021010)。

摘　　要：目的探讨小切口尺神经原位松解手术治疗肘管综合征的临床效果。方法选取2017年1月-2023年1月在南通大学附属常熟医院接受手术治疗的86例肘管综合征患者作为研究对象,随机分为两组,其中传统组43例,采用传统尺神经原位松解手术方案治疗;改良组43例,采用小切口尺神经原位松解手术方案治疗。对比两组的手术时间、切口长度、手术出血量、手术前后患肢感觉、握力、捏力、两点辨别觉、运动神经传导速度(MCV)、感觉神经传导速度(SCV)、疼痛程度、患侧肢体功能恢复效果。结果改良组患者的手术时间短于传统组,切口长度小于传统组,手术出血量少于传统组,上述各项指标经统计学分析差异均有统计学意义(P<0.05)。术前两组患肢的握力、捏力、MCV、SCV、两点辨别觉测定结果对比,差异无统计学意义(P>0.05);术后两组患肢的握力、捏力、MCV、SCV测定值与术前比较均显著升高,两点辨别觉与术前辨别距离比较显著降低,差异具有统计学意义(P<0.05),但两组间差异无统计学意义(P>0.05)。术前两组患肢的VAS评分对比差异无统计学意义(P>0.05);术后两组VAS评分均较术前显著降低,差异具有统计学意义(P<0.05),但两组间VAS评分差异无统计学意义(P>0.05)。疼痛程度均得到显著缓解,术后肢体功能恢复情况,改良组虽优于传统组,但差异无统计学意义(P>0.05)。结论小切口尺神经原位松解手术治疗肘管综合征与传统尺神经原位松解手术一样能取得较好的治疗效果,且具有手术创伤更小的优势。Objective To explore the clinical effect of a small incision in situ release surgery for ulnar nerve in the treatment of cubital tunnel syndrome.Methods A total of 86 patients with cubital tunnel syndrome who underwent surgical treatment in our hospital from January 2017 to January 2023 were selected as the study subjects and randomly divided into two groups.Among them,43 patients in the traditional group received traditional ulnar nerve in situ release surgery,while 43 patients in the improved group received small incision ulnar nerve in situ release surgery.The surgical time,incision length,surgical bleeding volume,and limb sensation of the affected side before and after surgery were compared between two groups Grip strength,pinching force,two-point discrimination,motor nerve conduction velocity(MCV),sensory nerve conduction velocity(SCV),degree of pain,and functional effectiveness of the affected limb.Results The surgical time of the improved group was shorter than that of the traditional group,the incision length of the improved group was shorter than that of the traditional group,and the surgical bleeding volume of the improved group was lower than that of the traditional group,with a statistically significant difference(P<0.05);Before surgery,there was no statistically significant difference in the grip strength,pinch strength,MCV,SCV,and two point discrimination measurements of the affected limb between the improved group and the traditional group(P>0.05);After the surgery,the above indicators were re examined.The grip strength,pinch strength,MCV,and SCV measurements of the affected limb in the improved group and the traditional group were significantly higher than before the surgery in this group,while the two point discrimination was significantly lower than before the surgery,with a statistically significant difference(P<0.05);There was no statistically significant difference in the grip strength,pinch strength,MCV,SCV,and the two point discrimination measurements of the affected limb between the improv

关 键 词：小切口 尺神经 松解手术 肘管综合征 

分 类 号：R688[医药卫生—骨科学]