Wintman B I, Winters S C, Gelberman R H, Katz J N
Harvard Combined Orthopaedic Surgery Program, Boston, MA, USA.
Clin Orthop Relat Res. 1996 May(326):135-45.
Fifty patients (54 hands) who underwent carpal tunnel release for carpal tunnel syndrome were evaluated to determine the relationship between the prominence of specific clinical symptoms and the early results of carpal tunnel release. Patients were evaluated preoperatively, 3 weeks after surgery, and 3 months after surgery by questionnaire, physical examination, and Semmes-Weinstein monofilament pressure testing. The symptoms evaluated included hand/wrist/forearm pain, night pain/paresthesias, intermittent paresthesias, hand clumsiness, hand weakness, constant numbness, and difficulty with work related tasks. All symptoms showed significant improvements at 3 months after surgery. Overall symptom reduction at 3 months after surgery was 49% +/- 73%. Overall satisfaction at 3 months after surgery was 7.8 +/- 2.8 (0 to 10 scale). the severity of preoperative subjective hand weakness was significantly associated with surgery and with less improvement of function at 3 months after surgery and with less satisfaction with overall symptom relief at 3 months after surgery. Although subjective outcomes in this study were markedly improved after carpal tunnel release regardless of preoperative symptomatology, patients with more preoperative night symptoms and intermittent paresthesias and less preoperative hand/wrist pain, numbness, weakness, clumsiness, and difficulty with work related tasks were the most satisfied with their surgery.
对50例（54只手）因腕管综合征接受腕管松解术的患者进行评估，以确定特定临床症状的突出程度与腕管松解术早期结果之间的关系。通过问卷调查、体格检查和Semmes-Weinstein单丝压力测试对患者进行术前、术后3周和术后3个月的评估。评估的症状包括手/腕/前臂疼痛、夜间疼痛/感觉异常、间歇性感觉异常、手部笨拙、手部无力、持续性麻木以及与工作相关任务的困难。所有症状在术后3个月均有显著改善。术后3个月总体症状减轻49%±73%。术后3个月总体满意度为7.8±2.8（0至10分制）。术前主观手部无力的严重程度与手术、术后3个月功能改善较少以及术后3个月对总体症状缓解的满意度较低显著相关。尽管无论术前症状如何，本研究中的主观结果在腕管松解术后均有明显改善，但术前夜间症状和间歇性感觉异常较多、术前手/腕疼痛、麻木、无力、笨拙以及与工作相关任务困难较少的患者对手术最满意。
