Akelman E, Weiss A P
Department of Orthopaedics, Brown University School of Medicine, Rhode Island Hospital, Providence, USA.
Orthop Clin North Am. 1995 Oct;26(4):769-78.
Carpal tunnel syndrome involves classic symptoms of numbness and paresthesias in the radial three and one-half digits, most frequently nocturnal, with pain associated with this anatomic distribution. Thenar weakness and autonomic dysfunction occurs late in these patients and are usually seen in advanced cases. The wrist flexion test and local percussion sensitivity tests done on physical examination can be helpful in determining and confirming the diagnosis of carpal tunnel syndrome. The likelihood that operative treatment will be required for resolution of symptoms is heightened if the patient is involved in daily manual repetitive activities of the hand or wrist. Surgical decompression can be accomplished by either a limited open or new endoscopic carpal tunnel release techniques. Currently, the advantages and disadvantages present in both procedures and careful controlled studies conducted in a prospective and randomized fashion will be required to further delineate the indications for either procedure. Carpal tunnel release remains an operative procedure with the most predictable outcome with relief of symptoms for the patient.
腕管综合征的典型症状是桡侧三个半手指麻木和感觉异常，最常见于夜间，疼痛与这一解剖分布区域相关。这些患者晚期会出现鱼际肌无力和自主神经功能障碍，通常见于病情严重的病例。体格检查时进行的屈腕试验和局部叩击敏感试验有助于确定和确诊腕管综合征。如果患者日常从事手部或腕部的重复性体力活动，那么通过手术治疗来缓解症状的可能性就会增加。手术减压可通过有限切开或新型内镜下腕管松解技术来完成。目前，这两种手术方式都有各自的优缺点，需要以前瞻性、随机方式进行仔细对照研究，以进一步明确每种手术方式的适应证。腕管松解术仍然是一种手术效果最可预测、能为患者缓解症状的手术。
