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微创超声引导下腕管松解术:长期临床疗效

Minimally invasive ultrasound-guided carpal tunnel release: long-term clinical outcomes.

作者信息

Honold Sarah, Loizides Alexander, Skalla Elisabeth, Gruber Leonhard, Plaikner Michaela, Gruber Hannes

机构信息

Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.

出版信息

Ultraschall Med. 2025 Sep 8. doi: 10.1055/a-2678-8214.

Abstract

In cases of severe or refractory carpal tunnel syndrome (CTS), carpal tunnel release (CTR) can be performed using open surgery, endoscopic techniques, or minimally invasive approaches under high-resolution ultrasound (HRUS) guidance. This study aimed to evaluate the long-term clinical outcomes following HRUS-guided CTR.A retrospective analysis was conducted on 302 HRUS-CTR cases. Patients who were available for a phone interview and had a minimum follow-up period of one year were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ). Symptom severity and functional limitations were compared before and after the procedure.Of the 302 cases screened, 111 cases had to be excluded due to unavailability for the phone call, missing data, or death. Accordingly, 191 cases were included. The average patient age was 60.4 ± 15.5 years (range: 19 to 87 years). 126 cases (66%) were female and 65 cases (34.0%) were male. Overall, there was a significant reduction of 91.9% in CTS-related symptom severity and frequency for all items recorded in the questionnaire. Similarly, a significant reduction of 84.8% in difficulty with all self-reported daily activities was found. In addition, the procedures were performed by four physicians showing no significant differences in technical success and symptoms reduction.HRUS-CTR is a safe and effective method for the treatment of CTS, showing a statistically but mostly clinically significant reduction in symptom severity and hand discomfort, which persisted 1 year after release and should therefore be considered as an alternative approach to open or endoscopic CTR.

摘要

对于严重或难治性腕管综合征(CTS)病例,可采用开放手术、内镜技术或在高分辨率超声(HRUS)引导下的微创方法进行腕管松解术(CTR)。本研究旨在评估HRUS引导下CTR的长期临床疗效。

对302例HRUS引导下CTR病例进行了回顾性分析。使用波士顿腕管问卷(BCTQ)对可进行电话访谈且随访期至少为一年的患者进行评估。比较手术前后的症状严重程度和功能受限情况。

在筛选的302例病例中,111例因无法进行电话访谈、数据缺失或死亡而被排除。因此,纳入191例病例。患者平均年龄为60.4±15.5岁(范围:19至87岁)。126例(66%)为女性,65例(34.0%)为男性。总体而言,问卷中记录的所有项目与CTS相关的症状严重程度和频率显著降低了91.9%。同样,自我报告的所有日常活动困难程度显著降低了84.8%。此外,手术由四位医生进行,在技术成功率和症状减轻方面无显著差异。

HRUS引导下CTR是一种治疗CTS的安全有效方法,症状严重程度和手部不适在统计学上有显著降低,且大多具有临床意义,在松解术后1年仍持续存在,因此应被视为开放或内镜CTR的替代方法。

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