Tsai Chia-Hsuan, Hsu Hsiang-Hao, Chen Shih-Heng, Chien Ling, Lin Jennifer An-Jou, Chang Chee-Jen, Kao Huang-Kai
From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Keelung & Chang Gung University College of Medicine.
Kidney Research Center, Department of Nephrology, Critical Care Nephrology Division.
Ann Plast Surg. 2020 Jan;84(1S Suppl 1):S100-S106. doi: 10.1097/SAP.0000000000002181.
Carpal tunnel syndrome (CTS) is a common cause of compression neuropathy of the upper extremities. This retrospective nationwide matched cohort study was conducted using the data from the Taiwan National Health Insurance Research Database between January 2003 and December 2012. The incidence rate of CTS was 975.84 and 544.12/100,000 person-years, respectively, yielding an incidence rate ratio of 1.79 (95% confidence interval, 1.68-1.91, P < 0.0001). CTS patients with End-stage renal disease (ESRD) in the dialysis group were more likely to receive surgical intervention than those the control group (62.41% vs 12.89%, P < 0.0001). The risk of CTS was significantly higher in the ESRD on dialysis cohort (10-year cumulative incidence, 8.0%) than in the control cohort (5.1%), which yielded an adjusted hazard ratio of 13.95 (95% confidence interval, 10.95-17.76, P < 0.0001). The high risk of CTS in ESRD patients on dialysis suggests that timely referral to hand surgeons with appropriate treatment should prevent permanent median nerve damage by CTS and may possibly improve patients' quality of life.
腕管综合征(CTS)是上肢压迫性神经病变的常见病因。本回顾性全国匹配队列研究利用了2003年1月至2012年12月台湾国民健康保险研究数据库中的数据。CTS的发病率分别为每10万人年975.84例和544.12例,发病率比为1.79(95%置信区间,1.68 - 1.91,P < 0.0001)。透析组中患有终末期肾病(ESRD)的CTS患者比对照组更有可能接受手术干预(62.41%对12.89%,P < 0.0001)。透析的ESRD队列中CTS的风险显著高于对照组队列(10年累积发病率,8.0%对5.1%),调整后的风险比为13.95(95%置信区间,10.95 - 17.76,P < 0.0001)。透析的ESRD患者中CTS的高风险表明,及时转诊至手外科医生并给予适当治疗应可预防CTS导致的永久性正中神经损伤,并可能改善患者的生活质量。