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腕管综合征患者局部注射类固醇的长期临床和电生理结果

Long-term clinical and electrophysiological results of local steroid injection in patients with carpal tunnel syndrome.

作者信息

Ayhan-Ardiç F F, Erdem H R

机构信息

Department of Physical Medicine and Rehabilitation, Ankara State Hospital, Turkey.

出版信息

Funct Neurol. 2000 Jul-Sep;15(3):157-65.

Abstract

The aim of this study was to evaluate the effects of local steroid injection on both the clinical symptoms and motor and sensory conduction of the median nerve in carpal tunnel syndrome (CTS). Using a standard evaluation and treatment protocol, we prospectively studied steroid injection in 32 hands in 24 patients (mean age: 50.7 +/- 10 years; 23 women and 1 man). To determine the normal median nerve values, 42 normal controls (mean age: 39.1 +/- 10.5 years; 21 women and 21 men) were also studied. At follow-up, clinical symptom scores and signs of CTS, as well as electrophysiological variables of the median nerve, showed a significant trend towards improvement with respect to baseline values (p < 0.01). By the end of the one-year follow-up period, the symptoms had remitted completely or partially in 27 hands (84.4%). In addition to the relief of the symptoms, motor nerve conduction abnormalities had improved in 62.6% of hands, and anti-dromic sensory nerve conduction abnormalities in 62.5%. In cases where a sensory nerve action potential (SNAP) could be obtained, the efficacy of this treatment was found to be relatively higher than in cases in which SNAP was absent (p < 0.01).

摘要

本研究的目的是评估局部注射类固醇对腕管综合征(CTS)患者临床症状以及正中神经运动和感觉传导的影响。我们采用标准的评估和治疗方案,对24例患者(平均年龄:50.7±10岁;23名女性和1名男性)的32只手进行了前瞻性类固醇注射研究。为确定正中神经的正常数值,还对42名正常对照者(平均年龄:39.1±10.5岁;21名女性和21名男性)进行了研究。随访时,CTS的临床症状评分和体征以及正中神经的电生理变量相对于基线值均呈现出显著的改善趋势(p<0.01)。到一年随访期结束时,27只手(84.4%)的症状已完全或部分缓解。除症状缓解外,62.6%的手运动神经传导异常得到改善,62.5%的手逆行感觉神经传导异常得到改善。在能够获得感觉神经动作电位(SNAP)的病例中,发现这种治疗的疗效相对高于未获得SNAP的病例(p<0.01)。

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