Poulenas I, Spertini F, Wauters J P
Service de Chirurgie Plastique et Reconstructive, CHUV 1011 Lausanne, Suisse.
Ann Chir Main. 1983;2(3):244-9. doi: 10.1016/s0753-9053(83)80006-4.
Out of 100 patients undergoing chronic hemodialysis in Lausanne (Switzerland), 12 developed a carpal tunnel syndrome (i.e. 8 men and 4 women, from 34 to 76 years old). Out of 66 patients with an arteriovenous fistula for less than 4 years, it is interesting to note that only 3 carpal tunnel syndrome were observed; whereas, out of 34 hemodialysis patients being dialyzed more than 4 years, 9 of them showed that syndrome. The symptomatology of the carpal tunnel syndrome is described by the authors. It has always been confirmed by EMG. On 10 patients, the symptoms were so acute that they needed a decompression of the median nerve. Five cases were bilateral. The operation is performed under axillary block, without tourniquet. The results were very satisfactory. Paresthesias disappeared after a few hours or a few days following the operation. No relationship could be established between CTS and the type of nephropathy, severity of polyneuropathy, Ca and P metabolism, vascular access complications, efficacity of dialysis, fluid overload or medical treatment. The authors are investigating the etiology of the carpal tunnel syndrome, ship hypothesize particularly concerning the direct or remote relation between the carpal tunnel syndrome and the arteriovenous fistula.
在瑞士洛桑接受慢性血液透析的100名患者中，有12人患上了腕管综合征（即8名男性和4名女性，年龄在34至76岁之间）。在66名动静脉内瘘使用时间不足4年的患者中，值得注意的是仅观察到3例腕管综合征；而在34名血液透析时间超过4年的患者中，有9人出现了该综合征。作者描述了腕管综合征的症状表现。这些症状均通过肌电图得到了证实。10名患者症状严重，需要进行正中神经减压手术。5例为双侧患病。手术在腋路阻滞下进行，不使用止血带。结果非常令人满意。术后数小时或数天内感觉异常消失。未发现腕管综合征与肾病类型、多发性神经病变严重程度、钙和磷代谢、血管通路并发症、透析效果、液体超负荷或药物治疗之间存在关联。作者正在研究腕管综合征的病因，特别推测了腕管综合征与动静脉内瘘之间的直接或间接关系。
