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糖尿病患者与非糖尿病患者腕管松解术的主观结果

Subjective Outcomes of Carpal Tunnel Release in Patients with Diabetes and Patients without Diabetes.

作者信息

Afshar Ahmadreza, Tabrizi Ali, Tajbakhsh Mojtaba, Navaeifar Nasrin

机构信息

Department of Orthopedics, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.

出版信息

J Hand Microsurg. 2020 Dec;12(3):183-188. doi: 10.1055/s-0039-1697059. Epub 2019 Nov 22.

Abstract

This study aims to compare the subjective outcomes of carpal tunnel surgery in the patients with diabetes and patients without diabetes, and it tries to determine the difference between insulin-dependent and noninsulin-dependent patients.  This retrospective cohort study compares subjective outcomes of 35 patients with type 2 diabetes and 35 patients without diabetes who had a unilateral carpal tunnel release. None of the patients with diabetes had neuropathy. All the patients had surgery by a single surgeon with miniopen incision under local anesthesia. The patients were evaluated before surgery and 6 months after surgery using two Brigham and Women's Carpal Tunnel Questionnaires  Carpal tunnel release was improved based on symptom severity scale (SSS) and functional status scale scores in patients with diabetes and nondiabetic patients. However, the mean SSS scores were higher in patients without diabetes 6 months after the surgery. Comparison between the mean SSS scores of the patients with diabetes showed higher scores in noninsulin-dependent patients. In patients with diabetes, SSS scores were positively correlated with carpal tunnel syndrome and diabetes durations.  The outcomes of carpal tunnel release were improved in both patients with diabetes and patients without diabetes suffering from median nerve compression at the wrist. However, the duration of diabetes and its treatment can be related to the severity of the disease symptoms after the carpal tunnel releasing surgeries. In some diabetic patients, the severity of the symptoms was persistent.  This is a prognostic level IV study.

摘要

本研究旨在比较糖尿病患者和非糖尿病患者腕管手术的主观结果,并试图确定胰岛素依赖型和非胰岛素依赖型患者之间的差异。 这项回顾性队列研究比较了35例2型糖尿病患者和35例非糖尿病患者单侧腕管松解术的主观结果。所有糖尿病患者均无神经病变。所有患者均由同一外科医生在局部麻醉下采用小切口开放手术。在手术前和手术后6个月,使用两份布莱根妇女医院腕管问卷对患者进行评估。 根据症状严重程度量表(SSS)和功能状态量表评分,糖尿病患者和非糖尿病患者的腕管松解术均有改善。然而,术后6个月非糖尿病患者的平均SSS评分更高。糖尿病患者的平均SSS评分比较显示,非胰岛素依赖型患者的评分更高。在糖尿病患者中,SSS评分与腕管综合征和糖尿病病程呈正相关。 糖尿病患者和非糖尿病患者手腕正中神经受压的腕管松解术结果均有改善。然而,糖尿病的病程及其治疗可能与腕管松解术后疾病症状的严重程度有关。在一些糖尿病患者中,症状的严重程度持续存在。 这是一项IV级预后研究。

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