内镜治疗腕管综合征的临床疗效观察△

Clinical observation on arthroscopic release for carpal tunnel syndrome

摘要:

［目的］探讨内镜治疗腕管综合征的临床效果。［方法］2018 年 9 月—2020 年 1 月，内镜松解治疗腕管综合征患者 28 例，其中男 5 例，女 23 例，年龄 46~62 岁，平均（53.15±7.89）岁。采用功能状态量表（BCTQ-FS）和症状严重程度量表（BC- TQ-SS）评价临床效果。行肌电图检查，测量运动神经电位潜伏期（Lat）、波幅（Amp）和感觉神经传导速度（SCV）。［结果］所有患者手术操作均在 10 min 内完成，出血量约 1 ml，术中无神经、血管及肌腱损伤。28 例患者均获随访，随访时间 6~12 个月，术后随时间推移，BCTQ-FS 评分、BCTQ-SS 评分均显著降低（P<0.05）。1 例因神经卡压时间过长，出现大、小鱼际肌萎缩，导致术后肌肉萎缩改善不明显。末次随访临床疗效评定为优 26 例，良 1 例，可 1 例，优良率为 96.77%。肌电图检查显示，与术前相比， 术后 Lat 显著减小（P<0.05），而 Amp 、SCV 显著增加（P<0.05）。［结论］内镜治疗腕管综合征，具有创伤小、效果显著等优点。

Abstract:

[Objective] To evaluate the clinical outcomes of arthroscopic release for carpal tunnel syndrome. [Methods] A retrospec- tive study was conducted on 28 patients who received arthroscopic release for carpal tunnel syndrome, including 5 males and 23 females aged from 46 to 62 years old, with a mean of (53.15±7.89) years. The Boston carpal tunnel questionnaires (BCTQ) , including functional state (FS) and symptom severity (SS) were used to evaluate the clinical outcomes, additionally, electrophysiological examinations, involving latency (Lat) and amplitude (Amp) of motor potential and sensory conduction velocity (SCV) were conducted. [Results] All the 28 patients had surgical procedures performed smoothly in 10 min with blood loss about 1 ml, while without injuries to the blood vessels, nerves and the tendons , and were followed up for 6~12 months. As time went both BCTQ-FS and BCTQ-SS significantly decreased (P＜0.05) . Of them, 1 patient developed greater and lesser thenar muscle atrophy due to nerve entrapment for too long period. The clinical outcomes were marked as excellent in 26 cases, good in 1 case and fair in 1 case, with excellent and good rate of 96.77%. In term of electrophysiological examination, the Lat decreased significantly, whereas the Amp and SCV increased significantly at the latest follow-up compared with those preoperatively (P＜0.05) . [Conclusion] The arthroscopic release of carpal tunnel syndrome has an advantage of smaller trauma, does achieve considerably satisfactory clinical outcomes.