Bena Antonella, Mamo C, Argentero O, Baratti A, Bruno Santina, Ferraris F, Demaria M
Servizio Regionale di Epidemiologia, ASL 5, Grugliasco.
Med Lav. 2007 Jul-Aug;98(4):320-30.
Carpal tunnel syndrome (CTS) is the most frequent entrapment neuropathy of the upper extremities. Despite CTS being a priority for public health, only a few studies have investigated the prevalence and incidence in the general population. In Italy, administrative data are available only for CTS cases which were judged work-related by the Workers Compensation Board. These data indicate a steady increase in CTS over the last decade. Hospital admission archives (SDO) also contain information on CTS patients who underwent surgery.
To determine: 1) the incidence and prevalence of first CTS, based on hospital records of patients who underwent surgery in the Piedmont Region; 2) to describe the geographical and temporal variation.
Crude and standardized incidence rates of CTS were computed for the period 2002-2003; geographical variation was assessed using bayesan estimators to detect spatial clusters. Crude and standardized prevalence rates of first hospitalization were calculated for every two-year period between 1996 and 2003.
The crude incidence rate was 227.2 (C.I.95% 221.9-232.7) per 100,000 women and 54.4 (C.I. 95% 51.9-57.1) per 100,000 men. The prevalence of first hospitalization was very high and varied widely by geographic area. Two possible explanations for such wide variation between areas include differences in exposure to risk factors for CTS and in the diagnostic criteria used. The increasing prevalence over time was only partly explained by an increase in work-related cases. The development of standardized diagnostic criteria would improve understanding of the effect of workplace exposures on CTS. The number of new cases per year in Piedmont was estimated at 1,500, much higher than the compensation claims related to CTS. Health education campaigns addressed to general practitioners on compensation law could improve reporting to the workers' compensation board.
腕管综合征（CTS）是上肢最常见的卡压性神经病变。尽管CTS是公共卫生的重点关注对象，但仅有少数研究调查了普通人群中的患病率和发病率。在意大利，行政数据仅涵盖被工人赔偿委员会判定与工作相关的CTS病例。这些数据表明，在过去十年中CTS呈稳步上升趋势。医院入院档案（SDO）也包含接受手术的CTS患者的信息。
确定：1）根据皮埃蒙特地区接受手术患者的医院记录，首次发生CTS的发病率和患病率；2）描述地理和时间变化情况。
计算2002 - 2003年期间CTS的粗发病率和标准化发病率；使用贝叶斯估计量评估地理变化，以检测空间聚集情况。计算1996年至2003年期间每两年首次住院的粗患病率和标准化患病率。
每10万名女性的粗发病率为227.2（95%置信区间221.9 - 232.7），每10万名男性为54.4（95%置信区间51.9 - 57.1）。首次住院的患病率非常高，且因地理区域差异很大。区域间如此大差异的两个可能原因包括CTS危险因素暴露的差异以及所使用的诊断标准的差异。随着时间推移患病率的增加仅部分归因于与工作相关病例的增加。制定标准化诊断标准将有助于更好地理解工作场所暴露对CTS的影响。皮埃蒙特地区每年的新病例数估计为1500例，远高于与CTS相关的赔偿申请数量。针对全科医生开展的关于赔偿法的健康教育活动可能会改善向工人赔偿委员会的报告情况。
