Bednarski Marek, Zyluk Andrzej, Zyluk Beata
Klinika Chirurgii Ogólnej i Chirurgii Reki, Pomorska Akademia Medyczna w Szczecinie.
Chir Narzadow Ruchu Ortop Pol. 2005;70(1):27-32.
Evaluation of changes of sensory disturbances, distribution of paresthesiae, and withdrawal of symptoms within 12 months after carpal tunnel release.
Thirty-nine patients with carpal tunnel syndrome (CTS) were evaluated for distribution of sensory disturbances. Two-point discrimination and filament testing were measured. The results were semi-quantitatively expressed as a sensory index. Distribution of paresthesiae were recorded on the whole hand, wrist and forearm. All patients completed the Levine questionnaire. Patients were assessed before the operation and at 3, 6 and 12 months after surgery. In all cases carpal tunnel was released by double incision open technique.
Sensory index for two-point discrimination fell from initial value of 1.7 to 1.4 at 3 months, and to 1.2 at 6 months and 1 year. Index for filament testing decreased from initial 2.5 to 1.8 at 3 months, 1.5 at 6 months, and 1.7 at 1 year. Subjective patients' satisfaction measured by symptomatic part of the Levine questionnaire improved significantly within first 6 months after surgery. Paresthesiae were initially experienced on middle fingertip in 90% of patients, on index fingertip in 80% and on thumb/annular fingertips in 70%. More than 50% patients complained of these symptoms to be present on little finger and 20% on the dorsal aspect of the fingers/hand. At 3 months less than 30% of the patients experienced paresthesiae on fingertips I-IV and 15% on little fingertip. At 1 year, 10% of patients still complained of paresthesias on middle and little fingertips.
Sensation improves statistically significantly within first 6 months after surgery, similarly to subjective patients' satisfaction assessed by the Levine questionnaire. Experience of paresthesiae in patients with CTS is not confined to the distribution of median nerve, although they are present most frequently at index and middle fingertips.
评估腕管松解术后12个月内感觉障碍的变化、感觉异常的分布以及症状的消退情况。
对39例腕管综合征（CTS）患者的感觉障碍分布进行评估。测量两点辨别觉和细丝试验。结果以感觉指数半定量表示。记录全手、腕部和前臂的感觉异常分布情况。所有患者均完成莱文问卷。在手术前以及术后3个月、6个月和12个月对患者进行评估。所有病例均采用双切口开放技术松解腕管。
两点辨别觉的感觉指数从初始值1.7在3个月时降至1.4，在6个月和1年时降至1.2。细丝试验指数从初始的2.5在3个月时降至1.8，在6个月时降至1.5，在1年时降至1.7。通过莱文问卷症状部分测量的患者主观满意度在术后前6个月内显著改善。90%的患者最初在中指指尖出现感觉异常，80%在食指指尖，70%在拇指/环指指尖。超过50%的患者抱怨小指出现这些症状，20%在手指/手背侧出现。在3个月时，不到30%的患者在示指至环指指尖出现感觉异常，15%在小指指尖出现。在1年时，10%的患者仍抱怨在中指和小指指尖有感觉异常。
术后前6个月感觉在统计学上有显著改善，与通过莱文问卷评估的患者主观满意度相似。CTS患者的感觉异常体验并不局限于正中神经的分布区域，尽管它们最常出现在食指和中指指尖。
