摘要
目的探索一种单切口和无需特殊器械即可完成的关节镜下治疗腕管综合征(CTS)的新技术体系,包括手术入路、手术标准操作流程、并发症预防及处理措施等技术环节。方法选取2012年4月-2015年3月由同一医师收治的46例特发性CTS患者,随机分为两组,传统开放手术组24例,改良内镜组22例。术后评价两组患者各医疗指标的差异,包括手术时间、平均住院时间、恢复工作/生活时间、术中副损伤率、术后切口感染率、临床症状缓解(Kelly评分)、术区疼痛评估、术后两点辨别觉恢复情况和交感神经营养不良发生率。结果两组在切口感染率、术中副损伤率、术后两点辨别觉恢复情况、交感神经营养不良发生率和临床症状缓解等方面比较差异无统计学意义,而改良关节镜下腕管松解组的术区疼痛评分、手术时间、住院时间以及恢复工作时间均明显低于传统开放手术组,差异有统计学意义(P<0.01)。结论单切口无特殊器械辅助内镜下松解术治疗CTS临床效果显著,是特发性CTS的有效治疗方法,值得推广。
Objective To explore a new technology system with single-portal and without special equipment to complete the arthroscopic treatment of carpal tunnel syndrome.Methods All the patients with CTS were randomly divided into two groups,modified endoscopic carpal tunnel release(MECTR)group(22cases)and open carpal tunnel release(OCTR)group(24cases).Nine parameters were evaluated,which including operation time,intraoperative complications,two-point discrimination3months after the operation,hospitalization time,scar pain score,incision infection rate,each patient's symptom amelioration(Kelly grading),the time needed to resume normal lifestyle and activity,symptoms of sympathetic dystrophy.Results No significant difference was observed between the MECTR group and OCTR group in regard to incision infection rate,intraoperative complications,two-point discrimination,symptoms of sympathetic dystrophy and clinical symptoms amelioration.In comparison to OCTS,MECTR significantly decreased operation time,hospitalization time,scar pain score and the time needed to resume normal lifestyle and activity.Conclusion MECTR for treatment of carpal tunnel syndrome has higher patient satisfaction,shorter operation time and hospitalization time,earlier return to work or normal lifestyle,less postoperative scar pain,so it is an effective method for the treatment of idiopathic carpal tunnel syndrome.
作者
涂俊波
张光明
覃健
Jun-bo Tu;Guang-ming Zhang;Jian Qin(Department of Orthopedics, the First People’s Hospital, Guangzhou Medical University, Guangzhou,Guangdong 510180, China;Department of Orthopedics, Sir Run Run Shaw Hospital,Nanjing Medical University, Nanjing, Jiangsu 211100, China)
出处
《中国内镜杂志》
北大核心
2017年第12期20-24,共5页
China Journal of Endoscopy
基金
南京市2016年度科技发展计划项目(No:201605066)
2016年度南京医科大学科技发展基金重点项目(No:2016NJMUZD036)
关键词
腕管综合征
内镜
关节镜
改良
carpal tunnel syndrome
endoscopy
arthroscopy
modified
作者简介
[通信作者]覃健，E-mail：qinjian@njmu.edu.cn；Tel：18351973783
