内窥镜辅助下治疗腕管综合征的方法

Endoscopic assisted carpal tunnel release

目的报告在内窥镜辅助下治疗腕管综合征的方法及长期疗效的随访分析。方法2002年4月—2003年4月,对14例18侧患腕管综合征的患者,在局部或臂丛神经阻滞麻醉下,腕部作1 cm长小切口,在正中神经前方置入"V"形槽,内窥镜辅助观察下,确认屈肌支持带后用推刀予以切断。结果术后第1天,8例患者表示手部原麻木感已消失,6例手部原麻木感明显改善;无明显并发症发生。术后随访2～4年,平均3.4年。按照Kelly分级标准评定,优良率为100%。腕部瘢痕小,患者对手术疗效十分满意。结论利用"V"形槽在内窥镜辅助下手术治疗腕管综合征的方法,其创伤小,术后恢复快,无明显并发症且长期疗效满意。

Objective To report the surgical procedure of endoscopic assisted carpal tunnel release and its long-term follow-up outcomes. Methods From April 2002 to April 2003, 18 sides of carpal tunnel syndrome in 14 patients were treated with endoscopic assisted carpal tunnel release. After local anaesthesia or brachial plexus nerve block, an incision 1 cm in length was made at the wrist. A steel tube with V-shaped groove was inserted into the carpal tunnel. Under endoscopic viewing, the transverse carpal ligament was identified and divided. Results The day after the surgery 8 patients reported complete relief of symptoms while the other 6 patients had partial relief. There was no complication. All patients were followed for 2 to 4 years （ mean： 3.4 years）. The satisfactory rate was 100% according to Kelly＇s criteria. The scar at the wrist was small. All patients were satisfied with the results. Conclusion Endoscopic assisted carpal tunnel release is safe and minimally invasive. The recovery time is short. It has good long-term results and very low complication rate.