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腕管松解术后扳机指的发病率:一项基于全国人群的回顾性队列研究。

Incidence of trigger digits following carpal tunnel release: A nationwide, population-based retrospective cohort study.

作者信息

Lin Fu-Yu, Manrique Oscar J, Lin Cheng-Li, Cheng Hsu-Tang

机构信息

Department of Neurology Division of Plastic and Reconstructive Surgery, Department of Surgery, China Medical University Hospital, China Medical University School of Medicine, Taichung City, Taiwan Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA School of Medicine, Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.

出版信息

Medicine (Baltimore). 2017 Jul;96(27):e7355. doi: 10.1097/MD.0000000000007355.

Abstract

The onset of trigger digits after carpal tunnel release (CTR) have been reported inconsistently across different studies. The aim of this study is to assess the incidence of trigger digits after CTR using nationwide population cohort data.We conducted a retrospective cohort study using the Longitudinal Health Insurance Database 2000 (LHID2000) from the National Health Insurance Database (NHIRD) in Taiwan. The LHID2000 contained 1 million beneficiaries randomly selected from the year 2000 Registry for Beneficiaries in NHIRD. We identified 2605 carpal tunnel syndrome (CTS) patients received CTR from 2000 to 2010 (CTR cohort, n = 2605). For each CTR patient, 4 CTS patients without CTR were randomly selected in the control cohort from the general population frequency matched by age, sex, and diagnosed year (non-CTR cohort, n = 10,420). Both cohorts were followed up until the end of 2011 to investigate the occurrence of trigger digits. Adjusted hazard ratios (aHRs) with 95% confidence interval (CI) of trigger digits were estimated using the Cox proportional hazards model after controlling for age, sex, and comorbidities.The CTR cohort had a mean follow-up period of 5.58 ± 3.18 years and the non-CTR cohort had a mean follow-up period of 5.90 ± 3.10 years. The overall risk of trigger digits was 3.63-fold greater in the CTR cohort than in the non-CTR cohort (incidence rate: 12.6 vs 3.38/1000 person-years, aHR: 3.63, 95% CI, 2.97-4.44). The incidence of postoperative trigger digits was highest in the 1st 6 months (incidence rate: 27.9/1000 person-years, aHR: 9.65, 95% CI, 5.27-17.7) and then significantly decreased over time.CTR was significantly associated with the subsequent development of trigger digits, especially in the postoperative 6 months.

摘要

不同研究中关于腕管松解术(CTR)后扳机指的发病情况报道并不一致。本研究旨在利用全国性人群队列数据评估CTR后扳机指的发生率。我们使用了台湾国民健康保险数据库(NHIRD)中的2000年纵向健康保险数据库(LHID2000)进行了一项回顾性队列研究。LHID2000包含从2000年NHIRD受益人登记册中随机选取的100万受益人。我们确定了2000年至2010年期间接受CTR的2605例腕管综合征(CTS)患者(CTR队列,n = 2605)。对于每例CTR患者,从普通人群中按年龄、性别和诊断年份进行频率匹配,随机选取4例未接受CTR的CTS患者作为对照队列(非CTR队列,n = 10420)。对两个队列进行随访至2011年底,以调查扳机指的发生情况。在控制年龄、性别和合并症后,使用Cox比例风险模型估计扳机指的调整风险比(aHRs)及其95%置信区间(CI)。CTR队列的平均随访期为5.58±3.18年,非CTR队列的平均随访期为5.90±3.10年。CTR队列中扳机指的总体风险比非CTR队列高3.63倍(发病率:12.6 vs 3.38/1000人年,aHR:3.63,95%CI,2.97 - 4.44)。术后扳机指的发病率在最初6个月最高(发病率:27.9/1000人年,aHR:9.65,95%CI,5.27 - 17.7),随后随时间显著下降。CTR与随后扳机指的发生显著相关,尤其是在术后6个月。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9f5/5502158/8bb0c74490ac/medi-96-e7355-g002.jpg

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