Scelsi R, Zanlungo M, Tenti P
Dipartimento di Patologia Umana ed Ereditaria, Università degli Studi, Pavia.
Ital J Orthop Traumatol. 1989 Mar;15(1):75-80.
Specimens of tenosynovial sheath in 80 patients affected with carpal tunnel syndrome were studied histologically and by ultrastructural methods. The specimens were obtained from patients who had been submitted to decompression with neurolysis of the median nerve and synovectomy of the flexor tendons. They were divided into two groups. The first group, consisting of patients with irritative or compressive symptomatology of recent occurrence, presented thickened and oedematous synovial sheaths, with histological inflammatory features and deposits of Types 1 and 2 collagen in the perivascular and interstitial sites. Ultrastructural analysis revealed deficits in the synovial sheath cells in addition to interstitial collagen deposits. The second group of longstanding carpal tunnel syndrome with severe signs of compression presented diffuse thickening of the sheaths, with extensive fibrosis associated with hyalinosis, and Type 3 collagen deposit which at times was amyloid. It is suggested that thickening of the synovial sheaths in carpal tunnel syndrome occurs in successive stages of a proliferative nature and successively of a regressive type, with extensive fibro-hyalinosis.
对80例腕管综合征患者的腱鞘标本进行了组织学和超微结构研究。标本取自接受正中神经松解减压和屈肌腱滑膜切除术的患者。将其分为两组。第一组由近期出现刺激性或压迫性症状的患者组成，其腱鞘增厚且水肿，具有组织学炎症特征，血管周围和间质部位有1型和2型胶原沉积。超微结构分析显示，除间质胶原沉积外，腱鞘细胞也有缺陷。第二组为长期存在且有严重压迫体征的腕管综合征患者，其腱鞘弥漫性增厚，伴有广泛的纤维化和透明变性，还有3型胶原沉积，有时呈淀粉样。提示腕管综合征中腱鞘增厚发生在增生性的连续阶段，随后是退行性类型，伴有广泛的纤维透明变性。
