摘要
目的比较尺神经原位松解术和皮下前置术两种手术方法治疗肘管综合征的疗效,为临床选择适当的治疗术式提供理论依据。方法 2009年3月~2012年10月收治64例肘管综合征患者,其中32例采用尺神经原位松解术（原位松解组）,32例采用尺神经皮下前置（皮下前置组）。两组患者性别、年龄、手术侧、病程及临床分型等一般资料比较,差异均无统计学意义（P〉0.05）,具有可比性。测量手术前后两组患者手部第一背侧骨间肌肌力、小指展肌肌力以及小指末节指腹皮肤测量两点辨别觉,肘上5cm~肘下5cm尺神经传导速度和术后并发症,进行比较。结果两组患者术后切口均Ⅰ期愈合。患者均获随访,随访时间24~32个月,平均27个月。末次随访时,二组患者手部第一背侧骨间肌肌力、小指展肌肌力及小指末节两点辨别觉,神经传导速度比较,差异均无统计学意义（P〉0.05）;但均较术前显著改善,差异有统计学意义（P〈0.05）。但尺神经原位松解组并发症的发生率6.25%明显低于皮下松解前置组25%,差异有统计学意义（P〈0.05）。结论尺神经单纯松解及皮下前置两种方法治疗肘管综合征均可达到良好疗效,其中尺神经原位松解法并发症较少。
Objective To compare the effectiveness of simple decompression and anterior subcutaneous transposition of the ulnar nerve in the treatment of cubital tunnel syndrome. Methods Between March 2009 and October 2012, 64 patients with cubital tunnel syndrome were treated separately by simple decompression（simple decompression group, n=32）and anterior subcutaneous transposition（anterior subcutaneous transposition group, n=32）. There was no significant difference in gender, age, duration, and clinical classification between 2 groups（P〉0.05）. Preoperatively, all patients presented with diminished 2-point discrimination. Postoperative sensory and motor recovery was evaluated clinically. We compared the nerve conduction velocities from 5cm above elbow to 5cm below elbow before and after the operation. Results All incisions healed by first intention in 2 groups. The patients were followed up 24 to 32 months, 27 months on average. There was no significant difference in muscle strength of the first dosal interosseous, muscle strength of the little finger abductor muscle, two-point discrimination of distal little fingers and the nerve conduction velocities between 2 groups（ P〉0.05）, but significant differences were found between before operation and after operation in 2 groups（ P〈0.05）.But the incidence of complications of the simple decompression group（6.25%） was lower than that in the group of subcutaneous release transposition（25%）. Conclusion Both the simple decompression and anterior subcutaneous transposition have good effectiveness in treating cubital tunnel syndrome; and simple decompression has less complication than that of subcutaneous transposition.
出处
《生物骨科材料与临床研究》
CAS
2015年第5期61-64,共4页
Orthopaedic Biomechanics Materials and Clinical Study
关键词
肘管综合征
尺神经原位松解术
尺神经皮下前置术
Cubital tunnel syndrome
Simple decompression
Ulnar nerve anterior subcutaneous transposition
