Wiesman Irvin M, Novak Christine B, Mackinnon Susan E, Winograd Jonathan M
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
Can J Plast Surg. 2003 Summer;11(2):70-2. doi: 10.1177/229255030301100205.
The present study evaluated the sensitivity, specificity and predictive values of six clinical tests in the diagnosis of carpal tunnel syndrome (CTS).
There were 29 carpal tunnel syndrome (CTS) subjects (mean age 48 years) and 30 control subjects (mean age 45 years). The six clinical tests included Tinel's sign, wrist flexion with fingers extended, wrist flexion with fingers flexed, wrist extension, combined wrist extension/median nerve pressure and combined wrist flexion/median nerve pressure.
The highest sensitivity and highest negative predictive value was found with wrist flexion with pressure (96%) and wrist extension with pressure (94%) at 60 s. The highest specificity was found with wrist flexion with fingers flexed for 30 s (95%). The highest positive predictive values were found with the wrist flexion with fingers flexed test for 30 s (91%) and the wrist extension test for 30 s (90%).
No one test possesses all the qualities necessary to be the ideal clinical test for the detection of carpal tunnel syndrome.
本研究评估了六项临床检查在诊断腕管综合征（CTS）中的敏感性、特异性和预测价值。
有29名腕管综合征（CTS）患者（平均年龄48岁）和30名对照者（平均年龄45岁）。这六项临床检查包括Tinel征、手指伸展时的腕关节屈曲、手指屈曲时的腕关节屈曲、腕关节伸展、腕关节伸展/正中神经加压联合检查以及腕关节屈曲/正中神经加压联合检查。
在60秒时，手指伸展时的腕关节加压屈曲（96%）和手指伸展时的腕关节加压伸展（94%）具有最高的敏感性和最高的阴性预测价值。手指屈曲30秒时的腕关节屈曲具有最高的特异性（95%）。手指屈曲30秒的腕关节屈曲试验（91%）和30秒的腕关节伸展试验（90%）具有最高的阳性预测价值。
没有一项检查具备成为检测腕管综合征理想临床检查所需的所有特性。
