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使用局部麻醉且不使用止血带进行开放性腕管松解术:出血倾向会影响手术结果吗?

Open carpal release using local anesthesia without a tourniquet: Does bleeding tendency affect the outcome?

作者信息

Lee Seongwon, Oh Sangho, Son Daegu

机构信息

Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Daegu, Korea.

W-Hospital, Daegu, Korea.

出版信息

Arch Plast Surg. 2020 Nov;47(6):597-603. doi: 10.5999/aps.2020.01732. Epub 2020 Nov 15.

Abstract

BACKGROUND

The aim of this study was to analyze the clinical results of minimal single palmar-incision carpal tunnel release without a tourniquet.

METHODS

We reviewed the medical records of 75 patients (90 cases of carpal tunnel syndrome) who underwent minimal single-palmar incision carpal tunnel release without a tourniquet from June 2010 to January 2018. Ten patients had a bleeding tendency. We compared the preoperative and postoperative Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) scores. We also analyzed outcomes and complications according to the presence of a bleeding tendency.

RESULTS

In all cases, there was a complete disappearance or marked improvement in symptoms within 6 months, with no recurrence. The postoperative BCTQ score showed a significant improvement compared to the preoperative score, and no statistically significant difference in BCTQ scores was detected according to the presence of a bleeding tendency.

CONCLUSIONS

Carpal tunnel release without a tourniquet using a minimal single palmar incision is effective and reliable. This technique prevents unnecessary pain associated with the tourniquet and is especially helpful in patients with a bleeding tendency or those treated with hemodialysis.

摘要

背景

本研究旨在分析不使用止血带的单手掌小切口腕管松解术的临床效果。

方法

我们回顾了2010年6月至2018年1月期间接受不使用止血带的单手掌小切口腕管松解术的75例患者(90例腕管综合征)的病历。其中10例患者有出血倾向。我们比较了术前和术后的波士顿腕管综合征问卷(BCTQ)评分。我们还根据是否存在出血倾向分析了手术结果和并发症。

结果

所有病例在6个月内症状完全消失或明显改善,无复发。术后BCTQ评分与术前评分相比有显著改善,根据是否存在出血倾向,BCTQ评分未检测到统计学上的显著差异。

结论

采用单手掌小切口不使用止血带的腕管松解术有效且可靠。该技术可避免与止血带相关的不必要疼痛,对有出血倾向的患者或接受血液透析治疗的患者尤其有帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a84a/7700870/dbf84565a069/aps-2020-01732f1.jpg

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