Rozmaryn L M, Dovelle S, Rothman E R, Gorman K, Olvey K M, Bartko J J
J Hand Ther. 1998 Jul-Sep;11(3):171-9. doi: 10.1016/s0894-1130(98)80035-5.
While developments continue in the surgical management of carpal tunnel syndrome, little emphasis has been placed on the evaluation of a comprehensive non-surgical treatment. In this study, 197 patients (240 hands) presenting for treatment of carpal tunnel syndrome were divided into two groups. Patients in both groups were treated by standard conservative methods, and those in one group were also treated with a program of nerve and tendon gliding exercises. Of those who did not perform the nerve and tendon gliding exercises, 71.2% underwent surgery compared with only 43.0% of patients who did perform them. Patients in the experimental group who did not undergo surgery were interviewed at an average follow-up time of 23 months (range, 14-38 months). Of these 53 patients, 47 (89%) responded to this detailed interview. Of the 47 who responded, 70.2% reported good or excellent results, 19.2% remained symptomatic, and 10.6% were non-compliant. Thus, a significant number of patients who would otherwise have undergone surgery for failure of traditional conservative treatment were spared the surgical morbidity of a carpal tunnel release (p = 0.0001).
尽管腕管综合征的外科治疗仍在不断发展，但对于全面的非手术治疗评估却很少受到重视。在本研究中，197例（240只手）因腕管综合征前来治疗的患者被分为两组。两组患者均采用标准保守方法治疗，其中一组患者还接受了神经和肌腱滑动练习计划。未进行神经和肌腱滑动练习的患者中，71.2%接受了手术，而进行了该练习的患者中只有43.0%接受了手术。对未接受手术的实验组患者进行了平均23个月（范围14 - 38个月）的随访访谈。在这53例患者中，47例（89%）回应了此次详细访谈。在回应的47例患者中，70.2%报告结果良好或优秀，19.2%仍有症状，10.6%不依从。因此，大量原本会因传统保守治疗失败而接受手术的患者避免了腕管松解术的手术并发症（p = 0.0001）。
