Schrijver Hans M, Gerritsen Annette A M, Strijers Rob L M, Uitdehaag Bernard M J, Scholten Rob J P M, de Vet Henrica C W, Bouter Lex M
Department of Neurology, VU University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
J Clin Neurophysiol. 2005 Jun;22(3):216-21.
The reported relationships between nerve conduction studies (NCS) and outcome measures in carpal tunnel syndrome (CTS) are weak to moderate. However, selection of patients may have confounded nonrandomized studies. NCS have potentially great value in selecting patients for a specific treatment and in objectively assessing the efficacy of treatments in CTS, especially if they correlate significantly with clinical outcome measures. To investigate the relationship between clinical outcome measures for the severity of complaints and NCS in patients treated for CTS, data were obtained from a multicenter randomized controlled trial on the efficacy of splinting versus surgery for CTS. At baseline and 12 months after randomization, clinical outcome measures were assessed and NCS were performed. In total, 138 patients completed the questionnaires and underwent repeated NCS. Relationships were analyzed with Spearman rank correlation coefficients and Pearson correlation coefficients. All NCS parameters showed highly significant improvement compared with baseline (P < 0.001). Modest correlations (< 0.4) were found between the neurophysiologic and clinical outcome measures after 12 months, and between the changes in these different categories of outcome measures. This study confirms that the parameters of NCS improve significantly after treatment for CTS, but the modest correlations between neurophysiologic and clinical outcome measures do not support that NCS are routinely performed in clinical practice to evaluate treatment effects. However, studies investigating the effects of treatment for CTS should incorporate both clinical outcome measures and NCS, because they are complementary. Furthermore, NCS can provide additional information to the clinician when treatment effects are unsatisfactory.
据报道，腕管综合征（CTS）中神经传导研究（NCS）与预后指标之间的关系较弱至中等。然而，患者的选择可能混淆了非随机研究。NCS在为特定治疗选择患者以及客观评估CTS治疗效果方面可能具有巨大价值，特别是如果它们与临床预后指标有显著相关性。为了研究CTS治疗患者中主诉严重程度的临床预后指标与NCS之间的关系，数据来自一项关于夹板治疗与手术治疗CTS疗效的多中心随机对照试验。在基线和随机分组后12个月，评估临床预后指标并进行NCS。共有138名患者完成了问卷调查并接受了重复的NCS。使用Spearman等级相关系数和Pearson相关系数分析关系。与基线相比，所有NCS参数均显示出高度显著的改善（P < 0.001）。在12个月后，神经生理学和临床预后指标之间以及这些不同类别预后指标的变化之间发现了适度的相关性（< 0.4）。本研究证实，CTS治疗后NCS参数有显著改善，但神经生理学和临床预后指标之间适度的相关性并不支持在临床实践中常规进行NCS以评估治疗效果。然而，研究CTS治疗效果的研究应同时纳入临床预后指标和NCS，因为它们是互补的。此外，当治疗效果不令人满意时，NCS可以为临床医生提供额外信息。
