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

Clinical application of limited incision of palm and wrist in the treatment of moderate-to-severe carpal tunnel syndrome

关键词:  腕管综合征  正中神经  神经卡压综合征  有限切开  腕管松解

Key words:  carpal tunnel syndrome  median nerve  nerve compression syndrome  limited open technique  limited incision  carpal tunnel release

摘要:

目的 探讨掌心联合腕部有限切开治疗腕管综合征的临床效果。方法 回顾性分析2016年11月至2018年5月应用掌心联合腕部有限切开治疗的腕管综合征33例（共35侧）患者的临床资料。其中男5例，女28例，年龄45~63岁，平均56.7岁。病程6~24个月，平均16.2个月。术后随访评价指标包括：患手麻木痛觉、感觉、拇指对掌功能的恢复及瘢痕痛，采用顾玉东腕管综合征功能评定标准评价疗效。结果 所有切口均一期愈合，瘢痕轻微。术后随访6~20个月，平均13.7个月。5侧出现瘢痕柱状痛，发生率为14.28%，6个月左右症状完全消失。顾玉东腕管综合征功能评定结果示：优25侧，良8侧，可2侧，差0侧。优良率94.3%。结论 掌心联合腕部有限切开松解腕横韧带创伤小，手术操作简单，疗效满意，是治疗中重度腕管综合征有效方法之一。

Abstract:

Objective To Study the clinical effects of limited incision on palm plus distal wrist crease in the treatment of moderate-to-severe carpal tunnel syndrome. Methods Retrospective analysis was performed on the clinical data utilizing limited incision on palm plus distal wrist crease in the treatment for patients with carpal tunnel syndrome from November 2016 to May 2018. A total of 35 sides of 33 patients were enrolled, including 5 men and 28 women with an average age of 56.7 years old (ranging from 45 to 63 years old). The course of the disease was 6 months to 24 months, with an average of 16.2 months. The recovery of numbness, pain, sensation and thumb opposition function of the affected hand and scar pain were examined after surgery. The curative effect was evaluated by the functional evaluation criteria of carpal tunnel syndrome (gu yudong). Results All incisions had primary healing and the palmar scars were mild. The patients were followed-up for 6 to 20 months (average of 13.7 months) postoperatively. Scar tissue pain occurred on 5 sides with an incidence of 14.28%; the symptoms disappeared completely in about 6 months. According to the functional evaluation criteria of carpal tunnel syndrome (gu yudong), the recovery was excellent in 25 sides, good in 8 sides, fair in 2 sides and poor in 0 side. Conclusion Limited incision on palm plus distal wrist crease is one of the effective methods to treat moderate-to-severe carpal tunnel syndrome.