关节镜下单通道双向原位松解术治疗肘管综合征的临床疗效  

Clinical efficacy of arthroscopic single channel bidirectional in-situ release surgery for the treatment of cubital tunnel syndrome

作　　者：冯祝 王培[1] 刘士波[1] 姜洪涛[1] 孔宇 霍明艳[1] 付世杰[1] Feng Zhu;Wang Pei;Liu Shibo;Jiang Hongtao;Kong Yu;Huo Mingyan;Fu Shijie(Department of Hand and Foot Surgery,Affiliated Hospital of Chengde Medical College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院手足外科,承德067000

出　　处：《中华手外科杂志》2025年第1期37-41,共5页Chinese Journal of Hand Surgery

基　　金：2022年承德市科技计划项目(202204A077)。

摘　　要：目的:探讨关节镜下单通道双向原位松解术治疗肘管综合征的临床疗效。方法:我科自2020年6月至2023年6月收治肘管综合征患者94例,分为观察组和对照组,观察组采用关节镜下单通道双向原位松解术,对照组采用开放原位松解术,对比两组患者术后的临床疗效。按照顾玉东推荐的肘管综合征功能评定标准,于术后6个月比较两组患者的小指末节两点分辨觉、尺神经肘上-肘下段运动神经传导速度(MCV)、尺神经腕-小指段感觉动作电位(SNAP)及改良Bishop法评价临床疗效,用MRI比较两组患者术前及术后尺神经在肘关节间隙远、近端2 cm内最大横截面积(CSA)。结果:两组患者术后小指末节两点分辨觉、尺神经MCV、SNAP、Bishop评分、CSA比较差异没有统计学意义,切口长度、手术时间、出血量的差异有统计学意义。结论:两种手术方式治疗肘管综合征效果相近,但关节镜下原位松解术较开放原位松解术,具有切口小、手术时间短、出血量少、术后并发症少的优点。Objective:To investigate the clinical efficacy of arthroscopic single channel bidirectional in-situ release surgery for the treatment of cubital tunnel syndrome.Methods:From June 2020 to June 2023,94 patients with cubital tunnel syndrome were treated in our department,who were divided into an observation group and a control group.The observation group underwent arthroscopic single channel bidirectional in-situ release surgery,while the control group underwent open in-situ release surgery.The clinical efficacy of the two groups of patients was compared after surgery.According to the functional evaluation criteria for cubital tunnel syndrome recommended by Gu Yudong,the two-point discrimination of the distal end of the little finger,the motor nerve conduction velocity(MCV)of the ulnar nerve in the upper and lower segments of the elbow,the sensory action potential(SNAP)of the ulnar nerve wrist-little finger segment were compared between the two groups of patients at 6 months after surgery,and the modified Bishop method was used to evaluate clinical efficacy.MRI was used to compare the maximum cross-sectional area(CSA)of the ulnar nerve within 2 cm of the elbow joint space before and after surgery between the two groups of patients.Results:There was no statistically significant difference in two-point discrimination,ulnar nerve MCV,SNAP,Bishop score,and CSA between the two groups of patients after surgery.However,there were statistically significant differences in incision length,surgical time,and bleeding volume.Conclusion:The two surgical methods for treating cubital tunnel syndrome have similar effects,but arthroscopic in situ release surgery has the advantages of smaller incision,shorter operation time,less bleeding,and fewer postoperative complications compared to open in situ release surgery.

关 键 词：肘管综合征 关节镜 磁共振成像 

分 类 号：R687.3[医药卫生—骨科学]