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腕管综合征手术:临床结局和患者满意度的预测因素。

Carpal tunnel surgery: predictors of clinical outcomes and patients' satisfaction.

机构信息

Department of Neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran.

Department of Neurosurgery, University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran.

出版信息

BMC Musculoskelet Disord. 2020 Jan 28;21(1):51. doi: 10.1186/s12891-020-3082-2.

Abstract

BACKGROUND

Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy. Moreover, carpal tunnel release (CTR) surgery generally has excellent results. The present study aimed to investigate the predictors of clinical outcomes and satisfaction in patients with CTR.

METHODS

In this observational prospective cohort study, 152 patients with open carpal tunnel release surgery were investigated. Complete clinical examinations were performed and recorded before the surgery, two weeks after the surgery and 6 months after the surgery. The Boston Carpal Tunnel Questionnaire (BCTQ) were assessed on admission and at last follow-up visits to evaluate clinical outcomes. Patients' satisfaction was determined by a 10-point verbal descriptor nominal scale (1 = very poor, 5 = fair and 10 = excellent) and recorded during the last follow -up visits.

RESULTS

Among 152 patients who were investigated, there were 118 (77.6%) females and 34 (22.36%) males. Overall, surgery improved the outcomes based on Symptom Severity Scale (SSS) and Functional Status Scale (FSS) (P < 0.05). Most of the considered variables did not show significant effects on clinical outcomes and patients' satisfaction. However, duration of symptoms and electrophysiological severity were the predictors of the change score in SSS(P < 0.05). As well as, age was the only predictor of the change score in FSS (P < 0.05). Finally, according to the linear regression model, the pre-operative grip strength and age were the independent predictors of post-operative satisfaction (P < 0.05).

CONCLUSIONS

Results of the present study revealed that there was a significant improvement in clinical outcomes after CTS surgery. Stronger pre-operative grip strength and younger age were independent predictors of higher post-operative satisfaction. These results can be used in pre-operative counseling and management of post-operative expectations.

摘要

背景

腕管综合征(CTS)是最常见的周围神经病变。此外,腕管松解(CTR)手术通常具有出色的效果。本研究旨在探讨 CTR 患者临床结果和满意度的预测因素。

方法

在这项观察性前瞻性队列研究中,调查了 152 例接受开放式腕管松解手术的患者。在手术前、手术后两周和手术后六个月进行了完整的临床检查和记录。在入院时和最后随访时使用波士顿腕管问卷(BCTQ)评估临床结果。通过 10 分的口头描述名义量表(1=非常差,5=一般,10=优秀)来确定患者的满意度,并在最后随访时记录。

结果

在接受调查的 152 例患者中,有 118 例(77.6%)为女性,34 例(22.36%)为男性。总体而言,手术改善了症状严重程度评分(SSS)和功能状态评分(FSS)的结果(P<0.05)。大多数考虑的变量对临床结果和患者满意度没有显著影响。然而,症状持续时间和电生理严重程度是 SSS 变化评分的预测因素(P<0.05)。同样,年龄是 FSS 变化评分的唯一预测因素(P<0.05)。最后,根据线性回归模型,术前握力和年龄是术后满意度的独立预测因素(P<0.05)。

结论

本研究结果表明,CTS 手术后临床结果有显著改善。术前握力越强,年龄越小,术后满意度越高。这些结果可用于术前咨询和术后期望的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f79c/6988299/ed48f1893d37/12891_2020_3082_Fig1_HTML.jpg

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