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振动病中的腕管综合征

Carpal tunnel syndrome in vibration disease.

作者信息

Koskimies K, Färkkilä M, Pyykkö I, Jäntti V, Aatola S, Starck J, Inaba R

机构信息

Institute of Occupational Health, Helsinki, Finland.

出版信息

Br J Ind Med. 1990 Jun;47(6):411-6. doi: 10.1136/oem.47.6.411.

Abstract

The presence of carpal tunnel syndrome (CTS) in 125 forestry workers with exposure to vibration was examined clinically by electromyography and by determining vibration detection thresholds. Numbness of the hands was present in 43%, history of diminished hand muscle force in 15%, and Raynaud's phenomenon in 27%. The muscle weakness correlated significantly with motor nerve conduction velocity in the median nerve in both hands. In 25 forestry workers CTS was diagnosed. The condition was bilateral in 48%; otherwise it was more common on the right side. Fifteen patients were referred for surgery but because of spontaneous recovery or refusal by the patients only five underwent surgery; of these four improved. The motor conduction velocity of the ulnar nerve was decreased among patients with CTS supporting the idea that entrapment neuropathies in the hands may be due to tissue swelling caused by vibration at work. Total exposure time to vibration correlated with the decrease in motor conduction velocity in the ulnar nerve.

摘要

通过肌电图检查和测定振动检测阈值,对125名接触振动的林业工人的腕管综合征(CTS)情况进行了临床检查。43%的工人存在手部麻木,15%有手部肌肉力量减弱史,27%有雷诺现象。双手肌肉无力与正中神经运动神经传导速度显著相关。25名林业工人被诊断为CTS。48%的病例为双侧患病;否则右侧更为常见。15名患者被转诊进行手术,但由于自发恢复或患者拒绝,只有5人接受了手术;其中4人病情好转。CTS患者的尺神经运动传导速度降低,支持手部卡压性神经病变可能是由于工作时振动导致组织肿胀的观点。总的振动暴露时间与尺神经运动传导速度的降低相关。

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本文引用的文献

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Raynaud's phenomenon due to vibrating tools; neurological observations.
Lancet. 1954 Jun 5;266(6823):1151-6. doi: 10.1016/s0140-6736(54)91666-9.
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Left-sided carpal tunnel syndrome in butchers.屠夫的左侧腕管综合征
Scand J Work Environ Health. 1983 Jun;9(3):291-7. doi: 10.5271/sjweh.2408.
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The carpal-tunnel syndrome. Clinical evaluation of 598 hands.腕管综合征。598只手的临床评估。
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Vibration-induced neuropathy among forestry workers.
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