Armstrong Timothy, Devor William, Borschel Laura, Contreras Richard
Department of Neurology, Kaiser Permanente, 4405 Vandever Avenue, San Diego, California 92120, USA.
Muscle Nerve. 2004 Jan;29(1):82-8. doi: 10.1002/mus.10512.
A double-blinded placebo-controlled trial was performed to evaluate the use of steroid injections beneath the transverse carpal ligament in the treatment of carpal tunnel syndrome (CTS) refractory to nonsurgical therapy. Forty-three patients received 6 mg betamethasone and lidocaine and 38 patients received 1 ml saline placebo and lidocaine. The primary outcome measure was satisfaction with symptom relief. Thirty patients (70%) in the steroid-treated group were satisfied or highly satisfied compared with 13 (34%) of placebo-treated patients (P < 0.001). Patients receiving steroids also showed significant improvement in median nerve conduction parameters and scores on validated symptom/function questionnaires. Forty-six patients were treated with serial injections for recurrent CTS symptoms. After 18 months, 17 patients reported adequate symptom relief with steroid injection, and 18 patients with unsatisfactory symptom relief were referred for carpal tunnel release surgery. We conclude that although steroid injections are safe and effective for temporary relief of CTS, most patients will eventually require surgery for long-term control of their symptoms.
进行了一项双盲安慰剂对照试验，以评估在腕横韧带下方注射类固醇治疗非手术治疗难治性腕管综合征（CTS）的效果。43例患者接受6mg倍他米松和利多卡因，38例患者接受1ml生理盐水安慰剂和利多卡因。主要结局指标是对症状缓解的满意度。类固醇治疗组有30例患者（70%）感到满意或非常满意，而安慰剂治疗组为13例（34%）（P<0.001）。接受类固醇治疗的患者在正中神经传导参数以及经过验证的症状/功能问卷评分方面也有显著改善。46例复发性CTS症状患者接受了系列注射治疗。18个月后，17例患者报告类固醇注射后症状得到充分缓解，18例症状缓解不满意的患者被转诊接受腕管松解手术。我们得出结论，虽然类固醇注射对CTS的临时缓解是安全有效的，但大多数患者最终需要手术来长期控制症状。
