腕管綜合征兩種手術方式的臨床對比研究

[摘要] 目的 研究對比單切口下內鏡腕管松解和傳統腕管開放性松解兩種術式治療腕管綜合征的療效。方法 方便選擇2010年12月—2015年12月該院骨二科63例腕管綜合征住院患者，分為單切口內鏡手術28例，對照組35例行傳統手術。比較兩組手術切口長度，住院時間、手術耗時及PRWE評分。結果 A組在切口長度（1.47±0.46）cm、手術耗時（33.07±4.29）min及住院天數（5.68±1.49）d上優于B組（3.62±0.86）cm，（35.49±3.68）min，（8.57±1.48）d，差異有統計學意義（t=11.665，2.266，7.282；P<0.05）。A組和B組PRWE評分在術后1個月比較，差異無統計學意義（P>0.05）；術后3個月和術后6個月比較，A組PRWE評分分別為（28.50±6.55）分，（16.59±4.69）分低于B組評分（32.60±6.87）分，（23.09±6.52）分，差異有統計學意義（t=2.286，4.282；P<0.05）。結論 單切口下內鏡技術治療腕管綜合征，不僅能充分達到治療效果松解正中神經，而且手術切口小、住院時間短、并發癥發生率低，適宜在臨床上推廣應用。

[關鍵詞] 腕管綜合征；內鏡

[中圖分類號] R4 [文獻標識碼] A [文章編號] 1674-0742（2016）12（b）-0025-04

Clinical Comparison of Two SurgicalMethods of Carpal Tunnel Syndrome

ZHU Zu-wei，HU Hua-qing，ZHENG Xiu-xia，WANG Xiao-yong，YANG Xu-dong

Department of Orthopedics， Ningde Hospital Affiliated to Fujian Medical University， Ningde ，Fujian Province，352100 China

[Abstract] Objective To compare the curative effects of two kinds of surgical treatment of carpal tunnel syndrome with single-incision for the dissection of the carpal tunnel and the open-release of the carpal tunnel. Methods Convenient selection from December 2010 to December 2015， 63 patients with carpal tunnel syndrome were divided into single-incision endoscopic surgery group （n = 28） and control group （n = 35）. The length of incision， length of hospital stay， operation time and PRWE score were compared between the two groups. Results The difference was statistically significant between group A and group B（3.62 ± 0.86）cm， （35.49 ± 3.68）min， （8.57 ± 1.48）d in incision length （1.47 ± 0.46）cm， operation time （33.07 ± 4.29）min and hospital stay（5.68 ± 1.49）d Significance （t = 11.665， 2.266， 7.282；P <0.05）. There was no significant difference in PRWE scores between group A and group B （P> 0.05）. The PRWE scores of group A and group B were （P <0.05）， the difference was not statistically significant（P> 0.05）. After 3 months and 6 months after operation， The PRWE score of group A was （28.50 ± 6.55）points，（32.60 ± 6.87）points lower than that of group B（16.59 ± 4.69）points，（23.09 ± 6.52）points， and the difference was statistically significant（t = 2.286， 4.282； P <0.05）. Conclusion The single - incision endoscopic treatment of carpal tunnel syndrome can not only fully achieve the therapeutic effect of loosening median nerve， but also has the advantages of small operative incision， short hospital stay and low complication rate. It is suitable for clinical application.

[Key words] Carpal tunnel syndrome； Endoscopy

腕管綜合征（Carpal tunnel syndrome，CTS）是嵌壓性神經疾病中最常見的一種，是由于正中神經在腕管部受壓引起的綜合征，臨床表現主要為手部的麻木、疼痛，后期可表現為魚際肌的萎縮[1-2]。傳統的治療方式主要是手術切開治療。隨著近年微創技術的發展，內窺鏡治療腕管綜合征得到了很大的發展[3]?，F將從2010年12月—2015年12月63例腕管綜合征行手術治療的患者情況，現報道如下。

1 資料與方法

1.1 一般資料

所有病例均方便選自該院腕管綜合征行手術治療的患者。手術方式根據患者經濟情況及自主意愿決定，手術方式為單切口內鏡下腕管松解術（A組）和傳統腕管開放性松解術（B組）。資料顯示，A組28例，其中男10例，女18例；……