Nanavati Nikhil, Walker-Bone Karen, Stanworth Helen, Williams Christopher
Ward 27, Bradford Teaching Hospital, Duckworth Lane, Bradford, West Yorkshire, BD9 6RJ, United Kingdom.
N Z Med J. 2013 Feb 15;126(1369):60-7.
Carpal tunnel syndrome (CTS) is the commonest peripheral neuropathy in the UK. The aim of this study was to characterise the satisfaction and evaluate the symptoms of postoperative patients having undergone open carpal tunnel decompression.
A questionnaire comprising of 6 sections was sent to 241 eligible participants. Subjects were asked to provide their demographic information and to quantify preoperative and postoperative numbness and tingling. The target population was also asked to indicate areas of postoperative numbness and tingling on a Katz hand diagram. Symptom severity and quality of life scores were also assessed.
This study received 89 usable responses. From analysis of the Katz hand diagrams if was possible to distinguish that 17 subjects (19.1%) had 'persistent' symptoms following carpal tunnel decompression and 72 subjects (80.9%) showed signs of symptomatic improvement. The 17 individuals with persistent symptoms were further assessed for significance between variables. Of these, most were of older age, mainly female, unemployed, with lower mental health and vitality scores. With significance testing, it was shown that lower mental health scores may contribute to a poorer response to surgery (p=0.096).
Most subjects experienced a positive response to surgical intervention, however, it may be necessary to screen patients for signs of depression before undertaking any surgery. By taking a more holistic preoperative assessment and aiding patients to seek treatment for any mental health conditions, this study postulates that outcomes of open carpal decompression could be improved.
腕管综合征(CTS)是英国最常见的周围神经病变。本研究旨在描述接受开放性腕管减压术的术后患者的满意度并评估其症状。
向241名符合条件的参与者发送了一份包含6个部分的问卷。受试者被要求提供其人口统计学信息,并对术前和术后的麻木及刺痛进行量化。还要求目标人群在凯茨手部示意图上指出术后麻木及刺痛的区域。同时也评估了症状严重程度和生活质量得分。
本研究收到了89份有效回复。通过对凯茨手部示意图的分析,可以区分出17名受试者(19.1%)在腕管减压术后有“持续”症状,72名受试者(80.9%)显示出症状改善的迹象。对这17名有持续症状的个体进一步评估变量之间的显著性。其中,大多数年龄较大,主要为女性,失业,心理健康和活力得分较低。通过显著性检验表明,较低的心理健康得分可能导致对手术的反应较差(p = 0.096)。
大多数受试者对手术干预有积极反应,然而,在进行任何手术前对患者进行抑郁症筛查可能是必要的。通过进行更全面的术前评估并帮助患者针对任何心理健康状况寻求治疗,本研究推测开放性腕管减压术的结果可能会得到改善。