Green D P
J Hand Surg Am. 1984 Nov;9(6):850-4. doi: 10.1016/s0363-5023(84)80065-9.
This retrospective study documents the diagnostic and therapeutic value of steroid injections in patients with carpal tunnel syndrome. Two hundred eighty-one injections in 233 patients were done by one surgeon who used the same technique. Adequate follow-up ranging from 6 to 45 months was obtained in 199 patients (222 wrists). Injection of the carpal tunnel is an effective, albeit usually transient, therapeutic modality. Eighty-one percent of the patients obtained good or complete relief lasting from 1 day to 45 months. In most of these, symptoms began to recur after about 2 to 4 months (average 3.3 months), but in only 46% were recurrent symptoms severe enough to warrant surgical treatment. Twenty of the patients injected had no recurrence of symptoms for periods ranging from 10 to 45 months. Results of this study suggest that carpal tunnel injection is also a reasonably accurate diagnostic test. Ninety-nine wrists in 89 patients were subsequently treated surgically. Correlations between results of injections and subsequent operations indicate that a good response to injection is an excellent diagnostic and prognostic sign. However, the converse is not true; poor relief from injection does not necessarily mean that the patient is a poor candidate for surgery.
这项回顾性研究记录了类固醇注射治疗腕管综合征患者的诊断和治疗价值。一名外科医生采用相同技术对233例患者进行了281次注射。199例患者（222只手腕）获得了6至45个月的充分随访。腕管注射是一种有效的治疗方式，尽管通常是短暂的。81%的患者获得了持续1天至45个月的良好或完全缓解。在大多数患者中，症状在约2至4个月（平均3.3个月）后开始复发，但只有46%的复发性症状严重到需要手术治疗。20例接受注射的患者在10至45个月期间没有症状复发。本研究结果表明，腕管注射也是一种相当准确的诊断测试。随后，89例患者中的99只手腕接受了手术治疗。注射结果与后续手术之间的相关性表明，对注射有良好反应是一个很好的诊断和预后指标。然而，反之则不然；注射后缓解不佳并不一定意味着患者不适合手术。
