摘要
目的探讨正中神经返支松解术在腕管综合征治疗中的临床疗效。方法回顾性分析2016年7月-2019年12月,经诊断为腕管综合征并给予腕管切开松解及返支松解术68例的临床资料。应用GSS评分,对患者术前及末次随访时的症状恢复情况进行综合评估;以及术后末次随访时,对正中神经远端运动潜伏期、中指-腕神经传导速度与术前做比较,对患者大鱼际肌功能恢复情况进行评估。结果本组68例73腕术后伤口均一期愈合,无伤口感染、皮肤坏死、神经损伤等并发症。运用GSS评分标准,从疼痛、麻木感、末梢神经感觉、夜间麻醒、肌力五个方面对腕管综合征术后恢复情况进行评分来判断术后疗效,患者症状明显改善。术后末次随访肌电图显示拇短展肌自主电位均消失,正中神经腕部潜伏期及腕-掌运动传导速度与术前比较,有明显改善,拇指大鱼际肌功能明显恢复。结论在治疗腕管综合征时,要重视正中神经返支,彻底去除卡压因素,对正中神经返支进行常规松解,才能使腕管综合征的治疗取得更好的效果。
Objective To discuss the clinical effect of median nerve recurrent branch release on the treatment of carpal tunnel syndrome(CTS). Methods From July 2016 to December 2019,68 patients with CTS were enrolled in the study, they were given carpal tunnel open release and recurrent branch release. The intraoperative and postoperative situations of 68 patients were observed and compared by GSS. At the last follow-up after surgery, the latency of distal median nerve movement and conduction velocity of middle finger - carpal nerve were compared with those before surgery, and the recovery of macrohypophysis muscle function was evaluated. Results All the wounds in the 68 patients with 73 hands healed in the first stage, had not wound infection, skin necrosis, nerve injury and other complications. The postoperative recovery of carpal tunnel syndrome was evaluated from five aspects, including pain, numbness, peripheral nerve sensation, nocturnal anesthesia and muscle strength, using GSS scoring standard to judge the postoperative efficacy, and the patient's symptoms were significantly improved. Electromyography (EMG) in the last follow-up showed that the autonomic potential of the abductor Polaris Polaris disappeared, the wrist incubation period of median nerve and the carpal motor conduction velocity were significantly improved compared with those before operation, and the muscle function of the thumb was significantly restored. Conclusion In the treatment of carpal tunnel syndrome, we should pay attention to the recurrent branch of the median nerve, completely remove the pressure factor, and perform routine release for the recurrent branch of the median nerve, so as to achieve better therapeutic effect for carpal tunnel syndrome.
作者
潘健鹏
缪玉龙
邵志恩
邓智明
朱文华
朱振兴
PAN Jianpeng;MIAO Yulong;SHAO Zhien(Department of Hand and Foot Surgery,Changshu Second People's Hospital Affiliated to Yangzhou University,Changshu,Jiangsu,215500,China)
出处
《实用手外科杂志》
2021年第3期312-314,共3页
Journal of Practical Hand Surgery
关键词
正中神经返支
松解术
腕管综合征
Median nerve recurrent branch
Release
Carpal tunnel syndrome