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新型器械辅助小切口与传统手术治疗腕管综合征的对比分析:109例回顾性研究

Comparative Analysis of a New Device-Assisted Mini-Incision Versus Conventional Surgery for Carpal Tunnel Syndrome: A Retrospective Study of 109 Cases.

作者信息

Guo Tianhao, Li Chenfei, Tian Dehu, Gao Ruijiao, Yu Kunlun, Sun Naichao, Yang Jing, Bai Jiangbo

机构信息

Department of Hand Surgery, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, 050051, People's Republic of China.

Department of Vascular Surgery, Hebei Medical University Third Hospital, Shijiazhuang, Hebei, 050051, People's Republic of China.

出版信息

Ther Clin Risk Manag. 2025 Apr 23;21:511-522. doi: 10.2147/TCRM.S514225. eCollection 2025.

Abstract

STUDY DESIGN

A retrospective cohort study.

OBJECTIVE

This study aimed to compare the effectiveness and safety of the new device-assisted mini-incision approach for carpal tunnel release (CTR) with the conventional method.

METHODS

A total of 109 patients diagnosed with primary carpal tunnel syndrome confirmed clinically were retrospectively included and divided into two groups based on the surgical approach: Group A (n=54) underwent surgery using a new device-assisted mini-incision, and Group B (n=55) received conventional surgery. Clinical outcomes, including pinch strength, grip strength, Visual Analog Scale (VAS) score, two-point discrimination (2-PD), Disabilities of the Arm, Shoulder, and Hand (DASH) score, and Boston Carpal Tunnel Questionnaire (BCTQ), were evaluated at 1, 3, and 6 months postoperatively. Additionally, operative time, incision length, wound pain, pillar pain, and the interval until return-to-work were compared between the two groups.

RESULTS

At the 6-month follow-up, all patients in both groups had recovered. There were no significant differences between the two groups in postoperative pinch strength ( = 0.665), grip strength ( = 0.803), 2-point discrimination (2-PD) ( = 0.347), Visual Analogue Scale (VAS) score ( = 0.143), Disabilities of the Arm, Shoulder and Hand (DASH) score ( = 0.524), and Boston Carpal Tunnel Questionnaire (BCTQ) (SSS: = 0.195; FSS: = 0.103). Statistically significant differences were observed between the two groups in operation time ( < 0.001), incision length ( < 0.001), and return to work time ( < 0.001). Although at 6-month follow-up, there was no significant difference in the incidence of wound pain and pillar pain between the two groups. But the incidence of wound pain and pillar pain was lower in Group A (wound pain: 0%; pillar pain:0%) compared to Group B (wound pain: 5.5%; pillar pain:7.3%).

CONCLUSION

The device-assisted mini-incision technique provided comparable functional results to the conventional approach, with reduced complications and smaller incisions, supporting its use as a viable alternative in appropriate cases.

摘要

研究设计

一项回顾性队列研究。

目的

本研究旨在比较新型器械辅助小切口腕管松解术(CTR)与传统方法的有效性和安全性。

方法

回顾性纳入109例临床确诊为原发性腕管综合征的患者,并根据手术方式分为两组:A组(n = 54)采用新型器械辅助小切口进行手术,B组(n = 55)接受传统手术。在术后1、3和6个月评估临床结果,包括捏力、握力、视觉模拟评分(VAS)、两点辨别觉(2-PD)、手臂、肩部和手部功能障碍(DASH)评分以及波士顿腕管问卷(BCTQ)。此外,比较两组之间的手术时间、切口长度、伤口疼痛、柱部疼痛以及恢复工作的间隔时间。

结果

在6个月的随访中,两组所有患者均已康复。两组在术后捏力(= 0.665)、握力(= 0.803)、两点辨别觉(2-PD)(= 0.347)、视觉模拟评分(VAS)(= 0.143)、手臂、肩部和手部功能障碍(DASH)评分(= 0.524)以及波士顿腕管问卷(BCTQ)(症状严重程度评分:= 0.195;功能状态评分:= 0.103)方面无显著差异。两组在手术时间(< 0.001)、切口长度(< 0.001)和恢复工作时间(< 0.001)方面存在统计学显著差异。虽然在6个月随访时,两组伤口疼痛和柱部疼痛的发生率无显著差异。但与B组(伤口疼痛:5.5%;柱部疼痛:7.3%)相比,A组伤口疼痛和柱部疼痛的发生率较低(伤口疼痛:0%;柱部疼痛:0%)。

结论

器械辅助小切口技术与传统方法的功能结果相当,并发症减少且切口更小,支持其在适当病例中作为一种可行的替代方法使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d945/12034282/590e8ebd1b55/TCRM-21-511-g0001.jpg

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