感觉过敏型腕管综合征的治疗

Treatment of carpal tunnel syndrome with algesia

目的报道7例感觉过敏型腕管综合征的诊治特点。方法收集与分析2002年3月至2005年3月间128例腕管综合征中感觉过敏型7例的病情及治疗特点。其中女性4例、男性3例。4例应用内镜治疗，3例切开治疗，经1—4年随访，平均随访时间1．5年。结果内镜治疗中2例疗效差，均在术中插入扩张导管时出现异常疼痛，另外2例基本满意。3例切开治疗中，2例疗效差，1例基本满意。3例基本满意中，2例内镜插入导管时均未出现疼痛，另1例为单纯切断腕横韧带，并在神经外膜下注射激素。结论感觉过敏型腕管综合征是一组特殊病例，保护神经外膜是治疗关键。

Objective To report the treatment of 7 cases of carpal tunnel syndrome （CTS） with algesia. Methods One hundred and twenty eight cases of carpal tunnel syndrome within the period of March 2002 and March 2005 were retrospectively analyzed. There were 7 cases （4 female and 3 male） had algesia, 4 cases were treated with endoscopic management of carpal tunnel release （ECTR） and 3 cases were treated with open management of carpal tunnel release （OCTR）. These 7 cases were followed-up 1-4 years （average 1.5 years） postoperatively. Results Two ECTR cases and 20CTR cases had bad therapeutic effect and the others had good effect. Both 2 bad-effect ECTR cases feel special pain when insert the catheter. Only inject Triamcinolone Acetonide-A within epineurlum after completely release in the goodeffect OCTR case. Condusion CTS with algesia is a special type of CTS, the key to treat it is to protect epineurium.