Zamora J L, Rose J E, Rosario V, Noon G P
Nephron. 1985;41(1):70-4. doi: 10.1159/000183549.
The clinical features of 88 patients who developed carpal tunnel syndrome (CTS) in association with end stage renal failure and chronic hemodialysis were studied (11 original cases and 77 collected from the literature). Hemodialysis-associated CTS was found to have a 2 to 1 male predominance, to occur more often in angioaccess-bearing (86%) than in unoperated arms (48%) (p = 0.005), and to require surgical release of the median nerve in most of the cases (86%). The analysis of 48 of these patients revealed two patterns of presentation. Patients with the 'early pattern' (41.6%) developed CTS within 1 year of commencing hemodialysis; diabetes mellitus and/or severe polyneuropathy were present in at least 40%. In contrast, patients with the 'late pattern' (58.4%) developed symptoms after at least 1 year on hemodialysis; diabetes mellitus and/or polyneuropathy were present in less than 10%. CTS should be considered in any hemodialysis patient with upper extremity neurological symptoms; early diagnosis and treatment will prevent loss of hand function.
对88例因终末期肾衰竭和慢性血液透析而并发腕管综合征（CTS）的患者的临床特征进行了研究（11例为原始病例，77例从文献中收集）。发现血液透析相关的CTS男性占比是女性的2倍，在有血管通路的手臂中发病更为常见（86%），而在未进行手术的手臂中发病率为48%（p = 0.005），并且大多数病例（86%）需要对正中神经进行手术松解。对其中48例患者的分析揭示了两种表现模式。“早期模式”的患者（41.6%）在开始血液透析后1年内出现CTS；至少40%的患者伴有糖尿病和/或严重的多发性神经病变。相比之下，“晚期模式”的患者（58.4%）在血液透析至少1年后出现症状；糖尿病和/或多发性神经病变的患者比例不到10%。任何出现上肢神经症状的血液透析患者都应考虑患有CTS；早期诊断和治疗将防止手部功能丧失。
