Burke Frank D, Wilgis E F Shaw, Dubin Norman H, Bradley Mary J, Sinha Shiladitya
The Pulvertaft Hand Centre, Derbyshire Royal Infirmary, Derby, England.
J Hand Surg Am. 2006 Nov;31(9):1478-82. doi: 10.1016/j.jhsa.2006.08.017.
There is no consensus regarding the prognostic value of preoperative symptom severity and duration for determining the anticipated results of carpal tunnel release. Some studies show a detrimental influence of symptom duration and severity on outcomes; others have found no effect. To study these contradictions, a database was created at 2 separate hand centers to explore the extent to which the duration and severity of symptoms before surgery are predictive of surgical outcome.
At 2 hand centers 523 hands from the United States and United Kingdom completed surgery and follow-up evaluation. Symptoms, time of onset, duration, prior treatment, and medical history were recorded. Each patient had a physical examination and completed the Levine-Katz questionnaire.
Symptom duration, corrected for gender, was not associated with Levine-Katz symptom severity, Levine-Katz functional status, or changes in these scores from the pretreatment to 6-month follow-up evaluations.
Preoperative symptom duration does not affect the surgery outcome as determined by the Levine-Katz symptom severity or functional status scores. The more severe the symptoms as determined by patient self-assessment, the greater the amount of change in the Levine-Katz symptom severity and functional status scores, although at 6 months after surgery the scores were still higher than those of patients with milder cases.
关于术前症状严重程度和持续时间对确定腕管松解术预期结果的预后价值，目前尚无共识。一些研究表明症状持续时间和严重程度对手术结果有不利影响；而其他研究则未发现有影响。为研究这些矛盾之处，在两个独立的手部中心建立了一个数据库，以探讨术前症状的持续时间和严重程度对手术结果的预测程度。
在美国和英国的两个手部中心，523例患者的手部完成了手术及随访评估。记录症状、发病时间、持续时间、既往治疗情况和病史。每位患者均接受了体格检查并完成了莱文-卡茨问卷。
校正性别后，症状持续时间与莱文-卡茨症状严重程度、莱文-卡茨功能状态或从术前到6个月随访评估中这些评分的变化均无关联。
根据莱文-卡茨症状严重程度或功能状态评分，术前症状持续时间不影响手术结果。患者自我评估确定的症状越严重，莱文-卡茨症状严重程度和功能状态评分的变化量就越大，尽管术后6个月时这些评分仍高于症状较轻患者的评分。
