Zeng Zeng, Lin Nan, Chen Cong-Xian
Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Zhejiang University School of Medicine, Hangzhou, China.
Front Neurol. 2023 Mar 29;14:1158688. doi: 10.3389/fneur.2023.1158688. eCollection 2023.
This retrospective study was to compare clinical outcomes of ultrasound-guided needle release with corticosteroid injection vs. mini-open surgery in patients with carpal tunnel syndrome (CTS). From January 2021 to December 2021, 40 patients (40 wrists) with CTS were analyzed in this study. The diagnosis was based on clinical symptoms, electrophysiological imaging, and ultrasound imaging. A total of 20 wrists were treated with ultrasound-guided needle release plus corticosteroid injection (Group A), and the other 20 wrists were treated with mini-open surgery (Group B). We evaluated the Boston carpal tunnel questionnaire, electrophysiological parameters (distal motor latency, sensory conduction velocity, and sensory nerve action potential of the median nerve), and ultrasound parameters (cross-sectional area, flattening ratio, and the thicknesses of transverse carpal ligament) both before and 3 months after treatment. Total treatment cost, duration of treatment, healing time, and complications were also recorded for the two groups. The Boston carpal tunnel questionnaire and electrophysiological and ultrasound outcomes at preoperatively and 3 months postoperatively had a significant difference for each group (each with < 0.05). There were no complications such as infection, hemorrhage, vascular, nerve, or tendon injuries in both groups. Ultrasound-guided needle release and mini-open surgery are both effective measures in treating CTS patients. Ultrasound-guided needle release plus corticosteroid injection provides smaller incision, less cost, less time of treatment, and faster recovery compared with mini-open surgery. Ultrasound-guided needle release plus corticosteroid injection is better for clinical application.
本回顾性研究旨在比较超声引导下针松解联合皮质类固醇注射与小切口手术治疗腕管综合征(CTS)患者的临床疗效。2021年1月至2021年12月,本研究分析了40例(40腕)CTS患者。诊断基于临床症状、电生理成像和超声成像。总共20腕接受超声引导下针松解联合皮质类固醇注射治疗(A组),另外20腕接受小切口手术治疗(B组)。我们在治疗前和治疗后3个月评估了波士顿腕管问卷、电生理参数(正中神经的远端运动潜伏期、感觉传导速度和感觉神经动作电位)以及超声参数(横截面积、扁平率和腕横韧带厚度)。还记录了两组的总治疗费用、治疗持续时间、愈合时间和并发症情况。每组术前和术后3个月的波士顿腕管问卷以及电生理和超声结果均有显著差异(均P<0.05)。两组均未出现感染、出血、血管、神经或肌腱损伤等并发症。超声引导下针松解和小切口手术都是治疗CTS患者的有效措施。与小切口手术相比,超声引导下针松解联合皮质类固醇注射切口更小、费用更低、治疗时间更短且恢复更快。超声引导下针松解联合皮质类固醇注射更适合临床应用。