Martin S D, Sharrock N E, Mineo R, Sobel M, Weiland A J
Department of Orthopaedics, Hospital for Special Surgery, Cornell Medical Center, New York, N.Y. 10021.
J Hand Surg Am. 1993 May;18(3):455-8. doi: 10.1016/0363-5023(93)90091-G.
Acute carpal tunnel syndrome that follows radial artery cannulation has been described. To determine the incidence and predisposing factors, we prospectively studied 151 patients who had perioperative radial artery cannulation. Postoperatively 9 of the 151 patients had symptoms of carpal tunnel syndrome with positive Phalen and Tinel signs on the side on which the radial artery catheter had been inserted. Eight of 12 patients with a prior history of carpal tunnel syndrome had acute exacerbation of symptoms postoperatively. By contrast, only 1 of 139 patients with no prior history of the disorder had symptoms. Fourteen patients had multiple arterial artery punctures or perforations of the posterior wall of the radial artery. In three of these, postoperative symptoms of carpal tunnel syndrome developed but did not reach statistical significance. The only patient with postoperative acute carpal tunnel syndrome but no prior history of the syndrome had multiple arterial punctures. The use of perioperative anticoagulation, the use of wrist-extension splints, and the duration of radial artery cannulation did not influence acute exacerbation of carpal tunnel syndrome. Patients with a prior history of carpal tunnel syndrome are at increased risk of recurrent symptoms after radial artery cannulation. We found no statistically significant relationship between traumatic cannulations and the development of symptoms of carpal tunnel syndrome.
已有文献报道桡动脉置管后出现急性腕管综合征的情况。为确定其发生率及易感因素，我们对151例围手术期行桡动脉置管的患者进行了前瞻性研究。术后，151例患者中有9例出现腕管综合征症状，在桡动脉导管插入侧的Phalen试验和Tinel征呈阳性。12例既往有腕管综合征病史的患者中有8例术后症状急性加重。相比之下，139例无该疾病既往史的患者中只有1例出现症状。14例患者存在桡动脉多处穿刺或后壁穿孔。其中3例出现了术后腕管综合征症状，但未达到统计学显著性。唯一术后出现急性腕管综合征但无该综合征既往史的患者存在多处动脉穿刺。围手术期使用抗凝药、使用腕部伸展夹板以及桡动脉置管时间并未影响腕管综合征的急性加重。既往有腕管综合征病史的患者在桡动脉置管后出现症状复发的风险增加。我们发现创伤性置管与腕管综合征症状的发生之间无统计学显著关系。
