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关于腕管综合征的多中心观察性调查:来自34个意大利中心的人口统计学和临床数据。

Observational multicentric survey on carpal tunnel syndrome: demographic and clinical data from 34 Italian centers.

作者信息

Luchetti R, Tognon S, Cacciavillani M, Ronco S, Buzzelli N, Lanni G

机构信息

Rimini Rehabilitation and Surgery Hand Center, Rimini, Italy.

出版信息

Eur Rev Med Pharmacol Sci. 2017 Feb;21(3):460-469.

Abstract

OBJECTIVE

To evaluate the current management of carpal tunnel syndrome (CTS) at a national level.

PATIENTS AND METHODS

A multicentric observational study was conducted in 34 Italian centers by specialists participating in the Management of Peripheral Neuropathies Study Group on 377 patients (age, mean±SD 56±14.4 years, 73.2% females) with CTS. The characteristics of the disease and its management were recorded at baseline and during a 2-month follow-up using a standardized clinical record and assessed with validated clinical tests.

RESULTS

A wide variability in the interventions prescribed and classified according to three categories (physical, pharmacological and neurotrophic therapies) was evident. A subgroup of 303 patients was treated with a combination of neurotrophic agents containing alpha-lipoic acid (ALA). At the end of the follow-up, a general improvement in symptoms and functional impairment was observed, with a significant reduction in BCTQ (Boston Carpal Tunnel Questionnaire) (p<0.001) and in NRS (Pain Numeric Rating Scale, p<0.001 for both nocturnal and diurnal pain).

CONCLUSIONS

An appropriate approach to CTS implies a multimodal and multidisciplinary management, involving several specialists and using a variety of conservative interventions. Conservative (physical and pharmacological) interventions can provide a clinical improvement in patients with CTS.

摘要

目的

在国家层面评估腕管综合征(CTS)的当前管理情况。

患者与方法

由参与周围神经病变管理研究组的专家在意大利的34个中心开展了一项多中心观察性研究,研究对象为377例腕管综合征患者(年龄,平均±标准差56±14.4岁,女性占73.2%)。使用标准化临床记录在基线时和2个月随访期间记录疾病特征及其管理情况,并通过经过验证的临床测试进行评估。

结果

根据三类(物理、药物和神经营养疗法)分类的所开干预措施存在很大差异。303例患者的一个亚组接受了含有α-硫辛酸(ALA)的神经营养药物联合治疗。随访结束时,观察到症状和功能障碍总体有所改善,波士顿腕管综合征问卷(BCTQ)显著降低(p<0.001),疼痛数字评定量表(NRS,夜间和日间疼痛的p值均<0.001)。

结论

对腕管综合征采取适当的方法意味着多模式和多学科管理,涉及多名专家并使用多种保守干预措施。保守(物理和药物)干预可使腕管综合征患者的临床症状得到改善。

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