摘要
目的 探讨小切口原位松解术对腕管综合征(CTS)病人手术指证、神经传导速度及上肢功能的影响。方法 2018年1月~2022年1月我院收治的CTS病人100例,采用随机数字表法分为两组,对照组50例,采用传统腕管松解术治疗;观察组50例,采用小切口原位松解术治疗。收集CTS病人的临床资料比较两组病人的手术指证、神经传导速度、上肢功能的变化及并发症发生率。结果 观察组的总有效率为98.00%,对照组为84.00%,两组比较,差异有统计学意义(P<0.05)。观察组CTS病人切口长度为(1.65±0.29)cm、开关切口时间为(4.85±1.02)分钟、住院时间为(3.24±0.62)天、术中出血量为(17.88±3.53)ml、术后1天VAS评分为(3.03±0.56)分,对照组分别为(4.02±0.81)cm、(10.06±2.28)分钟、(7.11±1.34)天、(24.37±5.27)ml和(4.04±0.89)分,两组比较差异有统计学意义(P<0.05)。治疗后,研究组CTS病人的拇指-腕感觉传导速度为(46.05±8.39)m/s、中指-腕感觉传导速度为(45.05±8.95)m/s、大鱼际肌-腕运动传导速度为(53.94±11.47)m/s、FIM自理能力评分为(34.38±7.22)分、FMA上肢评分为(34.23±7.25)分,对照组分别为(41.86±8.22)m/s、(40.88±8.28)m/s、(49.05±10.01)m/s、(27.81±6.01)分、(41.05±9.19)分,两组比较差异有统计学意义(P<0.05)。观察组并发症总发生率为4.00%,对照组为20.00%,两组比较差异有统计学意义(P<0.05)。结论 小切口原位松解术治疗CTS病人可改善病人手术指证、神经传导速度,有利于病人上肢功能的恢复,并降低术后并发症的发生率。
Objective To explore the effects of small incision in situ release on surgical indications,nerve conduction velocity and upper limb function in patients with carpal tunnel syndrome(CTS).Methods A total of 100 CTS patients admitted to our hospital from January 2018 to January 2022 were selected,they were randomly divided into the control group(50 cases,treated with traditional carpal tunnel release) and the observation group(50 cases,treated with small incision in situ release),the clinical data of CTS patients were collected and surgical indications,nerve conduction velocity,upper limb function and the incidence of complications were compared between the two groups.Results The total effective rate was 98.00% in the observation group and 84.00% in the control group(P<0.05).In the observation group,the length of incision was(1.65±0.29) cm,the time of opening and closing incision was(4.85±1.02) min,the hospitalization time was(3.24±0.62) d,the intraoperative blood loss was(17.88±3.53) mL,and the VAS score was(3.03±0.56) points one day after operation.The control group were(4.02±0.81) cm,(10.06±2.28) min,(7.11±1.34) d,(24.37±5.27) ml,(4.04±0.89) points,the differences were statistically significant(P<0.05).After treatment,The thumle-wrist sensory conduction velocity of CTS patients in the study group was(46.05±8.39) m/s,the middle finger-wrist sensory conduction velocity was(45.05±8.95) m/s,the thenar muscles-wrist motor conduction velocity was(53.94±11.47) m/s,the FIM ADL score was(34.38±7.22) points,and FMA The upper limb score was(34.23±7.25) points,and the control group was(41.86±8.22) m/s,(40.88±8.28) m/s,(49.05±10.01) m/s,(27.81±6.01) points,(41.05±9.19) points.The difference between the two groups was statistically significant(P<0.05).The total incidence of complications was 4.00% in the observation group and 20.00% in the control group(P<0.05).Conclusion Small incision in situ release is effective in the treatment of CTS patients,which can improve the surgical indications and nerve conduction velocity,help patients recover upper limb function,and reduce the incidence of postoperative complications.
作者
戴琰琨
解学关
刘畅
丁明胜
王禹苏
李霞
胡浩
黄旭
DAI Yankun;XIE Xueguan;LIU Chang;DING Mingsheng;WANG Yusu;LI Xia;HU Hao;HUANG Xu(Department of Hand and Foot Surgery,Huai'an Second People's Hospital,Jiangsu 223001,China)
出处
《临床外科杂志》
2024年第1期67-70,共4页
Journal of Clinical Surgery
基金
江苏省淮安市科技项目(HS2012002)。
关键词
小切口原位松解术
传统腕管松解术
腕管综合征
神经传导速度
上肢功能
small incision in situ release
traditional carpal tunnel syndrome
carpal tunnel syndrome
nerve conduction velocity
upper limb function
