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腕管松解术双小切口入路与传统入路的比较:一项回顾性研究。

Comparison of carpal tunnel release with double mini-incision approach and traditional approach: A retrospective study.

作者信息

Li Chenfei, Liu Yuxin, Zhang Bing, Lu Jian, Shi Xuyang, Yang Yipeng, Kong Lingde

机构信息

Hebei Medical University Third Hospital, Shijiazhuang, Hebei, PR China.

The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China.

出版信息

Medicine (Baltimore). 2025 May 16;104(20):e42510. doi: 10.1097/MD.0000000000042510.

Abstract

The aim of this study was to investigate the safety and efficacy of the double mini-incision approach, and to clarify its surgical details. We retrospectively enrolled 82 patients with primary carpal tunnel syndrome. Among them, 30 patients with conventional approach were enrolled in group A, and the other 52 patients with double mini-incision approach were enrolled in group B. Objective tests were performed on patients, and basic information and subjective evaluation of patients were collected. The surgical effects and complications of the 2 approaches were compared. In addition, the surgical details of double mini-incision were further explored. The incision length of group B (26.1 ± 6.1 mm) was significantly shorter than that of group A (45.7 ± 5.9 mm, P < .001). Patients in group B (93.7 ± 5.4) had significantly higher satisfaction with incision appearance than those in group A (84.3 ± 6.1, P < .001). At the 12-month follow-up, no statistically significant difference in clinical outcomes were observed between the 2 groups (P > .05). However, there were 2 cases with wound pain and 1 case with pillar pain in group A, but none in group B. Two patients in group B who underwent the distal incision 1st were transferred to the conventional approach because of the epineurium and perineurium injury. The double mini-incision approach offers a sufficient range of release and surgical field, resulting in favorable surgical outcomes. The proximal incision made 1st helps to reduce the risk of nerve injury.

摘要

本研究的目的是探讨双小切口入路的安全性和有效性,并阐明其手术细节。我们回顾性纳入了82例原发性腕管综合征患者。其中,30例行传统入路的患者纳入A组,另外52例行双小切口入路的患者纳入B组。对患者进行客观测试,并收集患者的基本信息和主观评价。比较两种入路的手术效果和并发症。此外,进一步探讨双小切口的手术细节。B组的切口长度(26.1 ± 6.1 mm)明显短于A组(45.7 ± 5.9 mm,P<.001)。B组患者对切口外观的满意度(93.7 ± 5.4)明显高于A组(84.3 ± 6.1,P<.001)。在12个月的随访中,两组的临床结果无统计学显著差异(P>.05)。然而,A组有2例伤口疼痛和1例柱部疼痛,而B组无。B组中2例先进行远端切口的患者因神经外膜和神经束膜损伤而转为传统入路。双小切口入路提供了足够的松解范围和手术视野,手术效果良好。先做近端切口有助于降低神经损伤的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec9b/12091664/a916baa2de29/medi-104-e42510-g001.jpg

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