Gautschi O P, Land M, Hoederath P, Fournier J-Y, Hildebrandt G, Cadosch D
Klinik für Neurochirurgie, Kantonsspital St. Gallen, Rorshacher Strasse 95, 9007 St. Gallen.
Praxis (Bern 1994). 2010 Feb 3;99(3):163-73. doi: 10.1024/1661-8157/a000020.
The carpal tunnel syndrome is the most common entrapment neuropathy (about 3% of the adults are affected). It is characterized by pain and paresthesia along the distribution of the median nerve. Thenar muscle atrophy with corresponding muscle weakness is a late manifestation of advanced disease. Electrophysiological tests are helpful in suggesting the diagnosis. An imaging with a magnetic resonance tomography may be used in the diagnosis of atypical cases. Ergonomic manoeuvres, oral steroids and steroidal injections may alleviate symptoms in mild cases. Surgical decompression of the carpal tunnel is the classical treatment of severe cases as well as for those who do not respond to conservative treatment. After surgery patients usually show excellent results. The following article discusses clinical aspects, diagnosis and current therapeutic options.
腕管综合征是最常见的卡压性神经病变(约3%的成年人受其影响)。其特征为沿正中神经分布区域出现疼痛和感觉异常。大鱼际肌萎缩及相应的肌肉无力是疾病晚期的表现。电生理检查有助于提示诊断。磁共振断层扫描成像可用于非典型病例的诊断。在轻症病例中,采用符合人体工程学的操作、口服类固醇药物及类固醇注射可能会缓解症状。腕管手术减压是重症病例以及对保守治疗无反应者的经典治疗方法。术后患者通常会取得良好效果。以下文章将讨论其临床方面、诊断及当前的治疗选择。