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开放性手术与内镜技术治疗腕管综合征的疗效相似:一项前瞻性随机试验

Similar effectiveness of the open versus endoscopic technique for carpal tunnel syndrome: a prospective randomized trial.

作者信息

Gümüştaş Seyit Ali, Ekmekçi Burcu, Tosun Haci Bayram, Orak Mehmet Müfit, Bekler Halil İbrahim

机构信息

Department of Orthopaedics and Traumatology, Yavuz Selim Bone Disease and Rehabilitation Hospital, Trabzon, Turkey.

Department of Neurology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey.

出版信息

Eur J Orthop Surg Traumatol. 2015 Dec;25(8):1253-60. doi: 10.1007/s00590-015-1696-0. Epub 2015 Aug 30.

Abstract

This prospective randomized study aims at evaluating the electrophysiological results of endoscopic and open carpal ligament release in patients with carpal tunnel syndrome. Included in the study were 41 patients diagnosed with carpal tunnel syndrome (21 hands in the endoscopic group and 20 hands in the open group). The Boston questionnaire was administered preoperatively and postoperatively to the patients, and their functional capacities and symptom severities were recorded. Physical examination was carried out preoperatively and in the postoperative sixth month. Demographic data and preoperative Boston symptomatic and functional scores were similar between both groups. A significant improvement was obtained in the Boston symptomatic and functional scores of both groups, but no significant difference was found between the groups in terms of improvement in the symptomatic and the functional scores. A significant shortening in median nerve motor distal latency and an increase in the velocity of sensory conductions were determined in both groups in the postoperative electromyography, but no difference was found between them in terms of improvement in the electromyography values. It was shown both clinically and electrophysiologically that endoscopic carpal tunnel surgery was as effective as open surgery as a treatment method for carpal tunnel syndrome.

摘要

这项前瞻性随机研究旨在评估腕管综合征患者内镜下和开放性腕管韧带松解术的电生理结果。该研究纳入了41例被诊断为腕管综合征的患者(内镜组21只手,开放组20只手)。术前和术后对患者进行波士顿问卷评估,并记录其功能能力和症状严重程度。术前和术后第六个月进行体格检查。两组之间的人口统计学数据以及术前波士顿症状和功能评分相似。两组的波士顿症状和功能评分均有显著改善,但在症状和功能评分的改善方面,两组之间未发现显著差异。术后肌电图检查发现,两组正中神经运动远端潜伏期均显著缩短,感觉传导速度均增加,但在肌电图值的改善方面,两组之间未发现差异。临床和电生理结果均表明,作为腕管综合征的一种治疗方法,内镜下腕管手术与开放手术同样有效。

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