Gulabi Deniz, Cecen Gultekin, Guclu Bulent, Cecen Aycicek
Orthopaedic and Traumatology Department, Dr. Lütfi Kırdar Kartal Training and Research Hospital, Semsi Denizer Cad. E5. Yanyol Cevizli Kavsagı Kartal, Istanbul, 34890, Turkey,
Eur J Orthop Surg Traumatol. 2014 Oct;24(7):1181-4. doi: 10.1007/s00590-014-1418-z. Epub 2014 Jan 20.
The aim of this prospective study was to compare the results of surgical decompression of carpal tunnel syndrome (CTS) in patients with diabetes mellitus with those with idiopathic CTS.
The results of surgical decompression of CTS in 27 patients with diabetes mellitus were compared with 42 patients with idiopathic CTS. All patients underwent surgical release of transverse carpal ligament by the mini-incision of palm technique. Patient self-administered Boston Questionnaire (BQ) for the assessment of severity of CTS symptoms and hand functional status was evaluated before and 6 months and 10 years after surgery.
After surgical release, all the patients of both groups reported an absence of pain, disappearance or reduction of paresthesia, and improvement in hand function. Six months after surgery, there was a significant improvement of symptomatic and functional BQ scores compared with preoperative state in both groups. Ten years after surgery, there was statistical difference in preoperative and postoperative 10th year functional BQ score between DM (-) and DM (+) (p < 0.01). DM status affected statistically functional BQ score between preoperative and postoperative 10th year.
Diabetes mellitus was a risk factor for poor outcome of surgical decompression of CTS. Patients with diabetes had worse surgical outcome compared with patients with idiopathic CTS in long-term follow-up.
本前瞻性研究的目的是比较糖尿病患者与特发性腕管综合征（CTS）患者腕管综合征手术减压的结果。
将27例糖尿病患者的CTS手术减压结果与42例特发性CTS患者的结果进行比较。所有患者均采用手掌小切口技术行腕横韧带松解术。采用患者自评的波士顿问卷（BQ）评估CTS症状严重程度和手部功能状态，在手术前、术后6个月和10年进行评估。
手术松解后，两组所有患者均报告疼痛消失、感觉异常消失或减轻，手部功能改善。术后6个月，两组患者的症状性和功能性BQ评分与术前状态相比均有显著改善。术后10年，糖尿病组（DM（-））和糖尿病组（DM（+））术前和术后第10年的功能性BQ评分存在统计学差异（p<0.01）。糖尿病状态在术前和术后第10年对功能性BQ评分有统计学影响。
糖尿病是CTS手术减压效果不佳的危险因素。在长期随访中，糖尿病患者的手术效果比特发性CTS患者差。
