Kumaş Ali, Warenburg Milly van de, Natroshvili Tinatin, Kemler Marius, Foumani Mahyar
Department of Plastic, Reconstructive and Hand Surgery, Martini Hospital, Groningen, The Netherlands.
Arch Plast Surg. 2023 Aug 2;50(4):398-408. doi: 10.1055/s-0043-1769739. eCollection 2023 Jul.
Carpal tunnel syndrome can be treated with corticosteroid injections (CIs) and surgery. In this systematic review, the influence of previous CI on different postoperative outcomes after carpal tunnel release is evaluated. A systematic literature search using several databases was performed to include studies that examined patients diagnosed with carpal tunnel syndrome who received preoperative or intraoperative CIs. Of 2,459 articles, 9 were eligible for inclusion. Four papers reported outcomes of preoperative and four outcomes of intraoperative CIs. One study evaluated patients who received both intraoperative and preoperative corticosteroids. Intraoperative CIs are associated with reduced postoperative pain after carpal tunnel release and support earlier recovery of the hand function that can be objectified in a faster median nerve conduction speed recovery and lower Boston Carpal Tunnel Questionnaire (BCTQ) scores. Using preoperative CIs did not lead to enhanced recovery after carpal tunnel release, and both preoperative and intraoperative CIs might be predisposing factors for infections.
腕管综合征可通过皮质类固醇注射（CIs）和手术进行治疗。在本系统评价中，评估了既往皮质类固醇注射对腕管松解术后不同结局的影响。
使用多个数据库进行了系统的文献检索，以纳入那些研究诊断为腕管综合征且接受术前或术中皮质类固醇注射的患者的研究。
在2459篇文章中，9篇符合纳入标准。4篇论文报告了术前皮质类固醇注射的结局，4篇报告了术中皮质类固醇注射的结局。1项研究评估了同时接受术中及术前皮质类固醇治疗的患者。
术中皮质类固醇注射与腕管松解术后疼痛减轻相关，并有助于手部功能更早恢复，这可通过正中神经传导速度更快恢复和更低的波士顿腕管综合征问卷（BCTQ）评分得以客观体现。术前使用皮质类固醇注射并未导致腕管松解术后恢复加快，且术前和术中皮质类固醇注射均可能是感染的诱发因素。
