有限小切口减压治疗对不同严重程度腕管综合征患者神经电生理参数的影响  

The impact of limited small incision decompression on neuroelectrophysiological parameters of patients with different severity of carpal tunnel syndrome

作　　者：叶明 黄宇旻 李威 张惠 Ye Ming;Huang Yumin;Li Wei;Zhang Hui(Department of Orthopaedics,Jiangsu Provincial Hospital(the First Affiliated Hospital of Nanjing Medical University),Nanjing 210029,China)

机构地区：[1]江苏省人民医院(南京医科大学第一附属医院)骨科,南京210029

出　　处：《临床内科杂志》2025年第3期213-216,共4页Journal of Clinical Internal Medicine

摘　　要：目的 探究有限小切口减压治疗对于不同严重程度腕管综合征(CTS)患者神经电生理参数的影响。方法 根据治疗方式的不同将178例CTS患者分为对照组(66例)和观察组(112例)。采用倾向性评分匹配法进行两组间1∶1匹配,最终成功匹配36对患者数据。收集所有患者治疗前后基线资料并分组进行比较。采用广义估计方程(GEE)模型分析患者治疗前后视觉模拟评分法(VAS)评分及Levine评分的差异。采用主效应分析和单独效应分析探讨不同严重程度CTS患者间神经电生理参数的差异。结果 治疗后两组患者VAS评分及Levine评分均低于同组治疗前,观察组VAS与Levine评分均低于同期对照组(P<0.001)。GEE模型分析结果显示,观察组患者治疗下降幅度大于对照组(P<0.05)。主效应分析结果显示,两组患者神经生理参数在时间效应、组间效应、交互效应方面均具有统计学意义(P<0.05)。单独效应检验结果显示,两组患者治疗前、治疗后3个月和治疗后6个月DML水平均依次升高,SCV、SNAP水平均依次降低;观察组患者治疗前、治疗后3个月和治疗后6个月DML水平均于同期对照,SCV、SNAP水平均高于同期对照组(P<0.05)。结论 相较于传统开放手术,有限小切口对于改善不同严重程度患者疼痛VAS评分、Levine评分、神经电生理参数的效果更明显。Objective To investigate the effect of limited small incision decompression on neurophysiologicalparameters in patients with carpal tunnel syndrome(CTS)of different severities.Methods According to the different treatment methods,178 CTS patients were divided into control group(66 cases)and observation group(112 cases).Propensity score matching method was used to perform 1:1 matching between the two groups,and 36 pairs of patient data were successfully matched.The baseline data of all patients before and after treatment were collected and compared between groups.The difference of visual analogue scale(VAS)and Levine score before and after treatment was analyzed by generalized estimation equation.Main effect analysis and single effect analysis were used to investigate the difference of neuroelectrophysiological parameters among patients with dferent severity of CTS.Results After treatment,VAS scores and Levine scores of two groups were lower than those before treatment,VAS and Levine scores of observation group were lower than those of control group during the same period(P<0.001).The results of GEE model analysis showed that the reduction of treatment in observation group was greater than that in control group(P<0.05).The results of main effect analysis showed that the neurophysiological parameters of two groups were statistically significant in time effect,inter-group effect and interaction effect(P<0.05).The results of the single effect test showed that the DML levels of two groups increased in turn before treatment,3 months and 6 months after treatment,and the SCV and SNAP levels decreased in turn.Before treatment,3 months and 6 months after treatment,the DML levels of observation group were higher than those of control group during the same period,and the SCV and SNAP levels were higher than those of control group during the same period(P<0.05).Conclusion Compared to traditional open surgery,limited small incision treatment demonstrated more pronounced effects in improving pain VAS and Levine scores,as well as

关 键 词：有限小切口治疗 腕管综合征 神经电生理参数 

分 类 号：R445.1[医药卫生—影像医学与核医学] R688[医药卫生—诊断学]