Effect Analysis of Single Channel Carpal Tunnel Release under Carpal Arthroscopy in the Treatment of Carpal Tunnel Syndrome
-
摘要:
目的 回顾分析腕关节镜下单通道腕管松解术治疗腕管综合征(CTS)的资料,探讨该术式的临床疗效。 方法 收集2020年12月至2021年12月之间昆明医科大学第一附属医院运动医学科收治的腕管综合征患者47例作为研究对象。所有患者均采用腕关节镜下单通道腕管松解术治疗腕管综合征,然后对所有患者进行至少6个月的随访,并运用改良波士顿腕管综合征评分量表(SSS评分和FSS评分),对患者术前与术后症状及功能恢复情况进行对比研究。 结果 经过随访研究,47例患者手麻症状及手功能较术前明显改善,术后手腕部疼痛等并发症发生率较低。治疗前SSS评分为(37.23±2.42),治疗后为(12.47±0.95),经比较差异有统计学意义(P < 0.05);治疗前FSS评分(10.00±1.12),治疗后为(30.76±2.64),经比较差异有统计学意义(P < 0.05)。 结论 腕关节镜下单通道腕管松解术治疗腕管综合征可以取得可靠的临床疗效,能够明显的缓解患者手麻等症状及提高手功能,术后疼痛等并发症较低,值得临床推广。 Abstract:Objective To review the data of carpal tunnel release surgery in the treatment of carpal tunnel syndrome (CTS) with carpal arthroscopy, and to explore the clinical effect of this operation. Methods 47 patients with carpal tunnel syndrome admitted in our department between December 2020 and December 2021 as the object in this study. All patients were treated with carpal tunnel syndrome by single-channel carpal tunnel release surgery under carpal arthroscopy, and all patients were followed up at least for 6 months. The recovery of symptoms and function before and after surgery was compared using the Modified Boston Carpal Tunnel Syndrome Score Scale (SSS score and FSS score). Results After follow-up investigation, the symptoms of hand anesthesia and function in 47 patients were significantly improved compared with those before surgery, and the incidence of postoperative wrist pain was small. SSS score was (47.53±2.2) before and (82.13±9.42) after surgery, and the difference was statistically significant (P < 0.05). FSS score was (10.00±1.12) before and (30.76±2.64) after surgery, and the difference was statistically significant (P < 0.05) . Conclusion Carpal arthroscopy single channel carpal tunnel release in the treatment of carpal tunnel syndrome can achieve reliable clinical efficacy, can significantly relieve patients with hand anesthesia and other symptoms, can reduce complication of postoperative pain and improve hand function, is worth popularizing in clinical use. -
表 1 手术治疗前、后SSS量表评分与FSS量表评分对比(
$\bar x \pm s $ ,分)Table 1. Comparison of SSS score and FSS score before and after surgical treatment (
$\bar x \pm s $ ,points)组别 SSS量表评分 FSS量表评分 术前 37.23 ± 2.42 10.00 ± 1.12 术后 12.47 ± 0.95 30.76 ± 2.64 F 4275.88 2463.65 P < 0.001 < 0.001 -
[1] Padua L,Coraci D,Erra C,et al. Carpal tunnel syndrome:clinical features,diagnosis,and management[J]. Lancet Neurol,2016,15(12):1273-1284. doi: 10.1016/S1474-4422(16)30231-9 [2] Talebi G A,Saadat P,Javadian Y,et al. Manual therapy in the treatment of carpal tunnel syndrome in diabetic patients:a randomized clinical trial[J]. Caspian J Intern Med,2018,9(3):283-289. [3] 吴亮,罗建光,唐贤翱,等. 腕管综合征复发7例分析[J]. 骨科,2022,13(1):8-11. doi: 10.3969/j.issn.1674-8573.2022.01.003 [4] Vihlborg P,Pettersson H,Makdoumi K,et al. Carpal tunnel syndrome and hand-arm vibration:a Swedish national registry case-control study[J]. J Occup Environ Med,2022,64(3):197-201. doi: 10.1097/JOM.0000000000002451 [5] Teng X,Xu J,Yuan H,et al. Comparison of wrist arthroscopy,small incision surgery,and conventional surgery for the treatment of carpal tunnel syndrome:a retrospective study at a single center[J]. Med Sci Monit,2019,25:4122-4129. [6] Orhurhu V,Orman S,Peck J,et al. Carpal tunnel release surgery- a systematic review of open and endoscopic approaches[J]. Anesth Pain Med,2020,10(6):e112291. [7] van den Broeke LR,Theuvenet WJ,van Wingerden JJ. Effectiveness of mini-open carpal tunnel release:An outcome study[J]. Arch Plast Surg,2019,46(4):350-358. doi: 10.5999/aps.2018.00535 [8] 曹维涵,梁红敏,朱梅,等. 超声对正常腕部神经干的检查价值[J]. 昆明医科大学学报,2016,37(9):120-124. doi: 10.3969/j.issn.1003-4706.2016.09.029 [9] 王丹,韦焘,段尉梅,等. 副肿瘤性周围神经病的神经电生理特点[J]. 昆明医科大学学报,2018,39(6):66-70. doi: 10.3969/j.issn.1003-4706.2018.06.014 [10] 金雷,肖海军,陆义安,等. 开放腕管松解术与关节镜下腕管松解术治疗腕管综合征的疗效比较[J]. 中国骨与关节损伤杂志,2021,36(7):763-765. doi: 10.7531/j.issn.1672-9935.2021.07.032 [11] Jiménez-Del-Barrio S,Cadellans-Arróniz A,Ceballos-Laita L,et al. The effectiveness of manual therapy on pain,physical function,and nerve conduction studies in carpal tunnel syndrome patients:a systematic review and meta-analysis[J]. Int Orthop,2022,46(2):301-312. doi: 10.1007/s00264-021-05272-2 [12] Zaralieva A,Georgiev G P,Karabinov V,et al. Physical therapy and rehabilitation approaches in patients with carpal tunnel syndrome[J]. Cureus,2020,12(3):e7171. [13] Multanen J,Ylinen J,Karjalainen T,et al. Reliability and validity of the finnish version of the Boston Carpal Tunnel Questionnaire among surgically treated carpal tunnel syndrome patients[J]. Scand J Surg,2020,109(4):343-350. doi: 10.1177/1457496919851607 [14] Multanen J,Uimonen M M,Repo J P,et al. Use of conservative therapy before and after surgery for carpal tunnel syndrome[J]. BMC Musculoskelet Disord,2021,22(1):484. doi: 10.1186/s12891-021-04378-3 [15] Schäfer L,Maffulli N,Baroncini A,et al. Local corticosteroid injections versus surgical carpal tunnel release for carpal tunnel syndrome:systematic review and meta-analysis[J]. Life (Basel).,2022,12(4):533-544. doi: 10.3390/life12040533 [16] Ayache A,Unglaub F,Langer M F,et al. Surgical treatment of carpal tunnel syndrome:open release of the flexor retinaculum and hypothenar fat flap for revision surgery[J]. Oper Orthop Traumatol,2020,32(3):219-235. doi: 10.1007/s00064-020-00662-y [17] 霍星辰,李永利,徐涛,等. 掌心联合腕部有限切开治疗中重度腕管综合征的临床应用[J]. 大连医科大学学报,2021,43(4):334-337. [18] 王小龙,韩超前,温树正,等. 三种小切口腕管松解术治疗腕管综合征的对比研究[J]. 中华手外科杂志,2020,36(2):106-110. doi: 10.3760/cma.j.cn311653-20190527-00156 [19] Karamanos E,Jillian B Q,Person D. Endoscopic carpal tunnel release:indications,technique,and outcomes[J]. Orthop Clin North Am,2020,51(3):361-368. doi: 10.1016/j.ocl.2020.02.001 [20] Chen Z,Liu J,Yuan T B,et al. Comparison of clinical outcomes between open and modified endoscopic release for carpal tunnel syndrome[J]. Exp Ther Med,2021,22(2):861-868. doi: 10.3892/etm.2021.10293