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无淀粉样沉积物的早期血液透析患者的腕管松解手术与静脉高压

Carpal tunnel release surgery and venous hypertension in early hemodialysis patients without amyloid deposits.

作者信息

Kocyigit Ismail, Unal Aydin, Guney Ahmet, Mavili Ertugrul, Deniz Kemal, Kocyigit Merva, Sipahioglu Murat, Eroglu Eray, Tokgoz Bulent, Gunal Ali Ihsan, Oymak Oktay

机构信息

Department of Nephrology, Erciyes University Medical Faculty, 38039 Kayseri, Turkey.

出版信息

ScientificWorldJournal. 2013 Nov 5;2013:481348. doi: 10.1155/2013/481348. eCollection 2013.

Abstract

AIM

Carpal tunnel syndrome (CTS) is one of the frequent problems of the patients who underwent hemodialysis (HD). The role of venous hypertension due to arteriovenous fistula (AVF) has not been clarified completely; therefore, we aimed to investigate the role of venous hypertension due to AVF in hemodialysis patients who had CTS.

PATIENTS AND METHODS

We included 12 patients who had been receiving HD treatment for less than 8 years and the newly diagnosed CTS patients with the same arm of AVF. All patients were diagnosed clinically and the results were confirmed by both nerve conduction studies and electromyography. Open carpal tunnel release surgery was performed on all of them. Venous pressure was measured in all patients before and after two weeks of surgery.

RESULTS

There were significant differences before and after the surgery with regard to pressures (P > 0.05). After the surgery, all carpal ligament specimens of the patients were not stained with Congo red for the presence of amyloid deposition.

CONCLUSION

Increased venous pressure on the same arm with AVF could be responsible for CTS in hemodialysis patients. Carpal tunnel release surgery is the main treatment of this disease by reducing the compression on the nerve.

摘要

目的

腕管综合征(CTS)是接受血液透析(HD)患者常见的问题之一。动静脉内瘘(AVF)导致的静脉高压的作用尚未完全阐明;因此,我们旨在研究AVF导致的静脉高压在患有CTS的血液透析患者中的作用。

患者与方法

我们纳入了12例接受HD治疗少于8年且同一手臂有AVF的新诊断CTS患者。所有患者均经临床诊断,结果通过神经传导研究和肌电图得到证实。对所有患者均进行了开放性腕管松解手术。在所有患者手术前及术后两周测量静脉压力。

结果

手术前后压力存在显著差异(P>0.05)。手术后,所有患者的腕横韧带标本均未用刚果红染色以检测淀粉样蛋白沉积。

结论

AVF同一手臂的静脉压力升高可能是血液透析患者CTS的原因。腕管松解手术通过减轻神经压迫是该病的主要治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3d2/3836390/3fd099bba63f/TSWJ2013-481348.001.jpg

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