内窥镜下单切口经腔外微创治疗腕管综合征  

Endoscopic extra-carpal tunnel release with a single supra-wrist transverse incision

作　　者：赵颖露 石慧征 徐静 贾潇天 劳杰 杨剑云 Zhao Yinglu;Shi Huizheng;Xu Jing;Jia Xiaotian;Lao Jie;Yang Jianyun(Department of Hand Surgery,Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China;Department of Hand Surgery,Yangquan Municipal No.3 People's Hospital,Yangquan 045000,China)

机构地区：[1]复旦大学附属华山医院手外科,上海200040 [2]阳泉市第三人民医院手外科,阳泉045000

出　　处：《中华手外科杂志》2025年第1期57-60,共4页Chinese Journal of Hand Surgery

摘　　要：目的:探讨内窥镜下应用单一腕部横切口经腔外切断腕横韧带治疗腕管综合征的手术方法,并评价其安全性与疗效。方法:我们自2022年10月至2023年7月对37例患者(共计56侧腕)采用腕部单一横切口、内窥镜下经腕管腔外切断腕横韧带治疗腕管综合征。结果:术后所有患者切口甲级愈合。37例患者均获得随访,时间12个月以上。随访患肢拇示中指末节两点分辨觉、握力,应用视觉模拟评分法(visual analogue scale,VAS)评估疼痛程度;术后随时间推移,握力逐渐恢复,VAS评分较术前明显降低,拇示中指末节两点分辨觉较术前改善。应用Kelly评定标准评定:优32例(48侧)、良5例(8侧),优良率100%。术后3个月5例患者有轻度瘢痕疼痛和轻度压痛,术后6个月所有患者上述症状基本消失,无神经损伤、血管损伤、肌腱损伤、血肿、感染、复发等并发症情况。结论:内窥镜下腕部横切口经腔外微创治疗腕管综合征的手术方法安全有效,具有可行性。Objective:To report the surgical procedure of endoscopic extra-carpal tunnel release with a single supra-wrist transverse incision and its follow-up outcomes.Methods:From October 2022 to July 2023,56 sides of carpal tunnel syndrome in 37 patients were treated with endoscopic extra-carpal tunnel release with single supra-wrist transverse incisions.Postoperative recovery was followed up.Results:All patients had primary healing of the incision,and were follow-up for more than 12 months.Visual analogue scale(VAS)was used to evaluate the degree of pain.With the passing of time after operation,the grip strength gradually recovered,the VAS was significantly lower than that before operation,and the two-point discrimination sense of the thumb index and middle finger was improved.According to Kelly evaluation criteria,32 cases(48 sides)scored excellent and 5 cases(8 sides)good,with an excellent and good rate of 100%.5 patients reported mild scar pain and tenderness at 3 months after surgery,yet fully recovered at 6 months after surgery.There were no occurrences of nerve injury,vascular injury,tendon injury,hematoma,infection,recurrence and other complications.Conclusion:Endoscopic extra-carpal tunnel release with a single supra-wrist transverse incision is a safe,effective and feasible procedure to treat carpal tunnel syndrome.

关 键 词：腕管综合征 正中神经 外科手术 微创性 

分 类 号：R687.3[医药卫生—骨科学]