超声动态评估神经周围注射50 g/L葡萄糖治疗轻中度腕管综合征的疗效  

Dynamic ultrasound assessment of perineural injection of glucose for the treatment of mild to moderate carpal tunnel syndrome

作　　者：柯淼[1] 黄粹业[1] 仇继任[1] KE Miao;HUANG Cui-ye;QIU Ji-ren(Department of Orthopedics,Qinzhou Second People's Hospital,Qinzhou 535000,Guangxi,China)

机构地区：[1]钦州市第二人民医院骨科,广西钦州535000

出　　处：《广东医学》2025年第3期419-424,共6页Guangdong Medical Journal

基　　金：广西壮族自治区卫生健康委员会科研课题(Z-N20231877)。

摘　　要：目的分析超声动态评估神经周围注射50 g/L葡萄糖治疗轻中度腕管综合征的疗效,以进一步明确50 g/L葡萄糖对正中神经功能预后的影响,辅助临床决策。方法前瞻性选取2022年4月至2023年4月期间住院治疗的80例轻、中度腕管综合征(CTS)患者为研究对象,根据检查方法分为50 g/L葡萄糖组(n=40)和皮质醇组(n=40),对比两组患者治疗前、治疗后1、3、6个月正中神经传导参数[感觉神经传导速度(sensory nerve conduction velocity,SCV)、正中神经运动末端潜伏期(distal median nerve motor latency,DML)、复合肌肉动作电位(complex muscle action potential,CMAP)波幅]和神经形态参数(前臂远端1/3、腕管入口(在软性骨水平)和腕管远端(在钩骨水平)三个部位正中神经横截面积(cross-sectional area,CSA)和神经平坦率(nervous frankness,NFR))。结果在治疗后1、3、6个月时,50 g/L葡萄糖组患者的SCV高于皮质醇组,而治疗后3、6个月时,50 g/L葡萄糖组患者的DML低于皮质醇组(均P<0.05)。在治疗后6个月时,50 g/L葡萄糖组患者的前臂远端1/3 CSA、腕管入口CSA、腕管远端CSA、前臂远端1/3 NFR、腕管入口NFR、腕管远端NFR低于皮质醇组(均P<0.05)。结论与皮质类固醇长期疗效相比,50 g/L葡萄糖神经注射是一种有效的治疗轻中度CTS的方法,可促进正中神经修复和再生,且超声动态可为治疗前后正中神经功能和形态提供客观依据,值得临床应用。Objective To analyze the efficacy of ultrasound dynamic assessment of perineural injection of 5%glucose in the treatment of mild to moderate carpal tunnel syndrome(CTS),with a focus on its impact on the prognosis of median nerve function,providing evidence to assist clinical decision-making.Methods A total of 80 patients with mild to moderate CTS who were hospitalized between April 2022 and April 2023 were prospectively selected for the study.The patients were divided into two groups based on the treatment method:the 5%glucose group(n=40)and the corticosteroid group(n=40).Median nerve conduction parameters(sensory nerve conduction velocity[SCV],distal median nerve motor latency[DML],complex muscle action potential[CMAP]amplitude)and morphological parameters(cross-sectional area[CSA]and nervous frankness[NFR]of the median nerve at the distal 1/3 of the forearm,carpal tunnel inlet,and distal carpal tunnel)were compared between the two groups before treatment,and at 1,3,and 6 months post-treatment.Results At 1,3,and 6 months post-treatment,the SCV in the 5%glucose group was higher than in the corticosteroid group,and at 3 and 6 months,the DML in the 5%glucose group was lower than in the corticosteroid group(all P<0.05).At 6 months post-treatment,the 5%glucose group had significantly lower CSA and NFR values at the distal 1/3 of the forearm,carpal tunnel inlet,and distal carpal tunnel compared to the corticosteroid group(all P<0.05).Conclusion Compared to the long-term efficacy of corticosteroids,perineural injection of 5%glucose is an effective treatment for mild to moderate CTS.It promotes the repair and regeneration of the median nerve,and ultrasound dynamic assessment provides an objective basis for evaluating median nerve function and morphology before and after treatment,making it a valuable tool for clinical application.

关 键 词：超声 腕管综合征 50 g/L葡萄糖 正中神经功能 

分 类 号：R816[医药卫生—放射医学] R445[医药卫生—临床医学]