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Osborne’s韧带悬吊尺神经前置术结合经皮神经肌肉电刺激在肘管综合征治疗中的应用

Application of Osborne's ligament suspension ulnar nerve anterior transposition combined with transcutaneous neuromuscular electrical stimulation in the treatment of cubital tunnel syndrome
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摘要 目的探究Osborne’s韧带悬吊尺神经前置术结合经皮神经肌肉电刺激在肘管综合征治疗中的应用。方法前瞻性选取2020年1月至2022年10月拟在秦皇岛市第一医院进行Osborne’s韧带悬吊尺神经前置术治疗的肘管综合征患者120例,按照随机数字表法分为两组,每组各60例。对照组行常规手术治疗,研究组在对照组患者治疗的基础上结合经皮神经肌肉电刺激治疗。比较两组术后分并指Lovett肌力分级、肘管综合征功能评分以及治疗前后肘上—肘下神经运动神经传导速度(MCV)及感觉神经传导速度(SCV)水平。结果术后6个月,两组患者的Lovett肌力分级、肘管综合征功能评分均有改善,Lovett肌力分级4、5级患者所占比例增大,且研究组术后6个月Lovett肌力4~5级占比、肘管综合征功能评分优良占比及肘管综合征功能评分为85.00%、90.00%、(12.56±2.15)分,均高于对照组[61.57%、70.00%、(11.02±4.15)分],差异均有统计学意义(P<0.05)。术后1、3个月,两组SCV、MCV均较术前升高,且研究组SCV分别为(47.55±6.65)、(53.66±5.46)m/s,MCV分别为(46.38±7.55)、(53.33±6.45)m/s,均高于对照组[(43.88±5.56)、(48.26±5.97)m/s以及(42.77±7.11)、(47.46±7.31)m/s],差异均有统计学意义(P<0.05)。结论在对肘管综合征患者进行治疗时,采用Osborne’s韧带悬吊尺神经前置术结合经皮神经肌肉电刺激可以有效提高患者的治疗效果,提高患者术后尺神经肌电图SCV、MCV水平,且安全性较好。 Objective To explore the application of Osborne's ligament suspension ulnar nerve anterior transposition combined with percutaneous neuromuscular electrical stimulation in the treatment of cubital tunnel syndrome.Methods A total of 120 patients with cubital tunnel syndrome who were treated by Osborne's ligament suspension and anterior transposition of ulnar nerve in the First Hospital of Qinhuangdao from January 2020 to October 2022 were prospectively divided into two groups according to the random number table method,with 60 cases in each group.The control group received routine surgical treatment,and the study group received transcutaneous neuromuscular stimulation on the basis of the treatment of the patients in the control group.The Lovett muscle strength grade,cubital canal syndrome function score,upper cubital-inferior elbow motor nerve conduction velocity(MCV)levels and sensory conduction velocity(SCV)levels were compared between the two groups before and after treatment.Results Six months after surgery,the Lovett muscle strength classification and cubital tunnel syndrome functional score of the two groups of patients were improved.The proportion of patients with Lovett muscle strength grade 4 and 5 was increased,and the Lovett muscle strength score of the study group was increased 6 months after surgery.The proportion of strength level 4-5,the proportion of excellent cubital tunnel syndrome functional score and the cubital tunnel syndrome functional score were 85.00%,90.00%,(12.56±2.15)points,which were all higher than those of the control group[61.57%,70.00%,(11.02±4.15)points],the differences were statistically significant(P<0.05).At 1 month and 3 months after surgery,SCV and MCV in two groups were higher than those before surgery,and SCV in the study group were(47.55±6.65),(53.66±5.46)m/s,respectively and MCV were(46.38±7.55),(53.33±6.45)m/s,respectively,which were higher than those in the control group[(43.88±5.56),(48.26±5.97)m/s,and(42.77±7.11),(47.46±7.31)m/s],and the differences were statistically significant(P<0.05).Conclusion In the treatment of patients with cubital tunnel syndrome,Osborne's ligament suspension of the ulnar nerve anterior transposition combined with transcutaneous neuromuscular electrical stimulation can effectively improve the therapeutic effect of patients,significantly increase the level of postoperative ulnar nerve EMG SCV and MCV,and has good safety.
作者 王蕊 田宇 李文艳 王维 WANG Rui;TIAN Yu;LI Wen-yan(Department of Hand and Foot Microsurgical Repair and Reconstruction Surgery,The First Hospital of Qinhuangdao,Qinhuangdao Hebei 066000,China)
出处 《临床和实验医学杂志》 2023年第24期2632-2636,共5页 Journal of Clinical and Experimental Medicine
基金 2020年度河北省医学科学研究课题计划(编号:202004A112)。
关键词 肘管综合征 Osborne’s韧带悬吊尺神经前置术 经皮神经肌肉电刺激 分并指Lovett肌力分级 Elbow tunnel syndrome Osborne's ligament suspension ulnar nerve anterior transposition Transcutaneous neuromuscular electrical stimulation Dividing and merging refers to Lovett muscle strength grading
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