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[腕管综合征的治疗]

[Carpal tunnel syndrome treatment].

作者信息

De Angelis Rossella, Salaffi Fausto, Filippucci Emilio, Grassi Walter

机构信息

Università Politecnica delle Marche, Dipartimento di Patologia Molecolare e Terapie Innovative, Cattedra di Reumatologia, Jesi (Ancona).

出版信息

Reumatismo. 2006 Jan-Mar;58(1):5-10.

Abstract

Carpal tunnel syndrome, the most common peripheral neuropathy, results from compression of the median nerve at the wrist, and is a cause of pain, numbness and tingling in the upper extremities and an increasingly recognized cause of work disability. If carpal tunnel syndrome seems likely, conservative management with splinting should be initiated. Moreover, it has suggested that patients reduce activities at home and work that exacerbate symptoms. Pyridoxine and diuretics, since are largely utilised, are no more effective than placebo in relieving the symptoms. Non steroidal anti-inflammatory drugs and orally administered corticosteroids can be effective for short-term management (two to four weeks), but local corticosteroid injection may improve symptoms for a longer period. Injection is especially effective if there is no loss of sensibility or thenar-muscle atrophy and weakness, and if symptoms are intermittent rather than constant. If symptoms are refractory to conservative measures, the option of surgical therapy may be considered.

摘要

腕管综合征是最常见的周围神经病变,由正中神经在腕部受压所致,是上肢疼痛、麻木和刺痛的一个原因,且越来越被认为是工作致残的一个原因。如果腕管综合征可能性较大,应开始使用夹板进行保守治疗。此外,建议患者减少在家中和工作中会加重症状的活动。维生素B6和利尿剂虽然大量使用,但在缓解症状方面并不比安慰剂更有效。非甾体抗炎药和口服皮质类固醇可有效用于短期治疗(两到四周),但局部皮质类固醇注射可能在更长时间内改善症状。如果没有感觉丧失或鱼际肌萎缩及无力,且症状为间歇性而非持续性,则注射尤其有效。如果症状对保守措施无效,可考虑手术治疗。

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