两种手术方式治疗腕管综合征的短期疗效分析  

Short term efficacy analysis of two surgical methods for the treatment of carpal tunnel syndrome

作　　者：李先仙 齐伟亚 白尚 张峰 裴广楠 吴衡 Li Xianxian;Qi Weiya;Bai Shang;Zhang Feng;Pei Guangnan;Wu Heng(Department of Orthopedics,People's Hospital of Xuyi County,Xuyi 211700,China;Department of Sports Medicine,Xuzhou Renci Hospital,Xuzhou 221004,China)

机构地区：[1]盱胎县人民医院骨科,盱眙211700 [2]徐州仁慈医院运动医学科,徐州221004

出　　处：《中华手外科杂志》2024年第6期540-544,共5页Chinese Journal of Hand Surgery

基　　金：江苏省卫生健康委员会指导性项目(Z2022049)。

摘　　要：目的对比分析两种手术方式治疗腕管综合征的短期疗效。方法选取自2023年1月至2023年6月徐州仁慈医院及盱眙县人民医院收治手术治疗的腕管综合征患者各20例,徐州仁慈医院采用腕关节镜辅助下腕横纹横行小切口手术方式、设为观察组,盱眙县人民医院采用掌根部鱼际纹纵行小切口手术方式、设为对照组,两组均将腕横韧带完全切断解除正中神经卡压。记录两组患者手术前资料、手术相关资料及手术后随访资料,术后6个月对两组患者恢复情况进行对比分析。结果两组患者均顺利完成手术且获得6个月的随访,未出现切口感染及愈合不良情况。观察组手术切口长度、手术时间及术中出血明显低于对照组,差异有统计学意义(P<0.05),但住院费用高于对照组(P<0.05)。两组患者术前疼痛视觉模拟评分(visual analogue scale,VAS)及改良波士顿腕管综合征评分量表评分(Boston carpal tunnel questionnaire,BCTQ;包括症状严重程度量表,symptom severity scale,SSS评分及功能状态量表,FSS评分)对比无明显差异,组内对比两组术后6个月VAS评分、SSS评分及FSS评分较术前明显降低,差异有统计学意义(P<0.05),组间对比观察组术后6个月VAS评分、SSS评分及FSS评分较对照组低,且差异有统计学意义(P<0.05)。术后6个月观察组无柱状痛及瘢痕痛,对照组存在3例柱状痛及6例瘢痕痛。按顾玉东腕管综合征功能评定标准评定优良率:观察组优良率100%,对照组优良率85%。结论两种手术方式治疗腕管综合征均可取得良好的短期疗效,腕关节镜辅助下手术疗效更为满意,但是费用相对增多。Objective To compare and analyze the short-term efficacy of two surgical methods in the treatment of carpal tunnel syndrome.Methods From January 2023 to June 2023,20 patients with carpal tunnel syndrome who underwent surgical treatment at Xuzhou Renci Hospital and Xuyi County People's Hospital were selected.Xuzhou Renci Hospital adopted a wrist arthroscopic assisted transverse small incision surgical method as the observation group,while People's Hospital of Xuyi County adopted a longitudinal small incision surgical method for the hypothenar crease at the root of the palmas the control group.Both groups completely cut off the transverse carpal ligament to relieve the compression of the median nerve.The preoperative data,surgical related data and postoperative follow-up data of two groups of patients were recorded,and the recovery status of the two groups of patients at 6 months after surgery was compared and analyzed.Results Both groups of patients successfully completed the surgery and received a 6-month follow-up,and no incision infection or poor healing occurred.The length of surgical incision,operation time,and intraoperative bleeding in the observation group were significantly lower than those in the control group,with statistical significance(P<0.05),but the hospitalization cost was higher than that in the control group(P<0.05).There was no significant difference in preoperative pain visual analogue scale(VAS)and modified Boston Carpal Tunnel Questionnaire(BCTQ)scores(including symptom severity scale,symptom severity scale,SsS score and functional status scale,functional status scale,FSS score)between the two groups of patients before surgery.Within the group comparison,the VAS score,SSS score,and FSS score of the two groups at 6 months after surgery were significantly lower than before,and the difference was statistically significant(P<0.05).Between the groups,the VAS score,SSS score,and FSS score of the observation group at 6 months after surgery were lower than those of the control group,and the differen

关 键 词：腕管综合征 外科手术 腕关节镜 小切口 

分 类 号：R688[医药卫生—骨科学]