内镜直视下微创外科技术治疗狭窄性腱鞘炎

Mini-invasion surgical treatment of stenosing tenosynovitis by endoscopical technique assisted

[目的]对屈指肌腱狭窄性腱鞘炎采用自制腱鞘松解器在内镜直视下松解A1滑车的方法治疗，观察治疗效果．并讨论目前常用的开放手术和经皮盲切技术的有关问题。[方法]对11例狭窄性腱鞘炎患者采用自制腱鞘松解器在内镜直视下松解A1滑车的方法治疗，结合临床体会阐述其手术操作技术。[结果]11例患者手指屈伸受限和扳机指现象完全缓解．大部分疼痛症状消失。无神经损伤、切口感染或延迟愈合、手无力等并发症出现。在随访期间（6～36个月），无症状复发。[结论]采用自制腱鞘松解器在内镜直视下治疗狭窄性腱鞘炎，手术成功率高，安全有效，并发症少，在狭窄性腱鞘炎的治疗具有一定优越性。特别对曾经实施封闭治疗、患有糖尿病和拇指狭窄性腱鞘炎的患者有应用价值。

[ Objective] To treat stenosing tenosynovitis by a kind of mini-invasion operation with endscopy assisted, and to observe the clinical results, and to discuss the problem of open and percutaneous A1 pulley release. [ Method] Eleven cases, suffering from stenosing tenosynovitis, were treated by the technique of mini-invasion operation with endscopy assisted with a kind of special release knife. The clinical results was investigated and the operative methods was investigated. [ Result] All of the patients showed relieving of symptoms of disfunction and trigger finger. There was no serious complication, such as injury of nerves, infection, wound ununion and hand disability. None recurrent case in the follow-up period of 6 to 36 months. [ Conclusion] The method of miniinvasion surgical treatment of stenosing tenosynovitis by endscopical technique assisted is safe, effective and low-cost with few complications, which fit for treating stenosing tenosynovitis, specially for those patients with cortisone injection, diabetes and thumb stenosing tenosynovitis.