Department of Nephrology, Jagiellonian University, Collegium Medicum, Cracow, Poland.
Med Sci Monit. 2011 Sep;17(9):CR505-9. doi: 10.12659/msm.881937.
Carpal tunnel syndrome (CTS) is the most common complication of dialysis-related amyloidosis (DRA) developing in patients on long-term dialysis therapy. The aim of this study was to evaluate the incidence of CTS and identify factors influencing the development of CTS in patients on maintenance hemodialysis, as well as results of its surgical treatment.
MATERIAL/METHODS: The study included 386 patients, among whom CTS was diagnosed in 40 patients (10.4%) on the basis of signs and physical symptoms, as well as by nerve conduction. The group of patients with CTS and the group of patients without CTS were compared according to age (mean 54.50 vs. 56.48 years) and duration of dialysis treatment. Initial analysis of CTS incidence by sex, presence of anti-HCV antibodies, and location of arterio-venous fistula (AV fistula) was undertaken.
Duration of dialysis treatment was the statistically significant risk factor for the development of CTS (16.05 vs. 4.51 years; p<0.0001). Among patients treated for a long period on hemodialysis (20-30 years), 100% required surgical release procedures, while 66.66% of those treated for 15-19 years, 42.1% of those treated for 10-14 years, and 1.6% of those treated for less than 10 years. CTS was diagnosed more often in anti-HCV-positive patients as compared with anti-HCV-negative patients (47.5 vs. 6.9%; p<0.0001). No significant differences were found when comparing CTS incidence by sex or between the development of CTS requiring surgical release intervention and location of the AV fistula.
Surgical release procedure of the carpal tunnel gave good treatment results in patients with CTS.
腕管综合征（CTS）是长期透析治疗患者中透析相关淀粉样变（DRA）发展的最常见并发症。本研究旨在评估维持性血液透析患者 CTS 的发生率，并确定影响 CTS 发生的因素，以及 CTS 的手术治疗结果。
材料/方法：本研究纳入了 386 例患者，其中 40 例（10.4%）根据体征和物理症状以及神经传导诊断为 CTS。根据 CTS 患者和无 CTS 患者的年龄（平均 54.50 岁比 56.48 岁）和透析治疗时间进行比较。对 CTS 发生率按性别、抗 HCV 抗体和动静脉瘘（AV 瘘）位置进行初步分析。
透析治疗时间是 CTS 发生的统计学显著危险因素（16.05 年比 4.51 年；p<0.0001）。在长期接受血液透析治疗的患者（20-30 年）中，100%需要手术松解术，而治疗 15-19 年的患者中 66.66%、治疗 10-14 年的患者中 42.1%、治疗 10 年以下的患者中 1.6%需要手术松解术。与抗 HCV 阴性患者相比，抗 HCV 阳性患者的 CTS 诊断率更高（47.5%比 6.9%；p<0.0001）。在按性别比较 CTS 发生率或比较需要手术松解干预的 CTS 发生率与 AV 瘘的位置时，未发现显著差异。
腕管松解术为 CTS 患者提供了良好的治疗效果。
