改良微创术与传统切开法治疗单侧发病腕管综合征的比较研究

Clinical comparative study of reforming endoscopic minimally invasive releasing versus open procedure for unilateral carpal tunnel syndrome

目的比较改良内窥镜微创切开腕管减压与传统切开法治疗腕管综合征的术后疗效。方法将70例单侧发病的腕管综合征患者随机分为改良内窥镜微创切开腕管减压（改良微创治疗组）与传统切开治疗组，每组35例，采用Kelly评分、两点分辨觉的改善、手术时间及并发症的发生情况作为评价指标，比较两组术式的疗效。结果术后常规随访12个月，两种术式的疗效优良率和两点分辨觉的改善差异均无统计学意义（P均〉0．05），但改良内窥镜微创治疗组的手术时间[（10．03±1．84）min与（37．63±7．18）min，t=22．210，P〈0．001]明显少于传统切开组；且未出现瘢痕触痛，而传统切开组7例出现瘢痕触痛。结论改良内窥镜微创切开腕管减压手术创伤小、手术耗时短，疗效则与传统腕管切开减压术等同。

Objective To compare the efficacy of the reforming endoscopic minimally invasive releasing（REMIR） with open procedure for treatment of carpal tunnel syndrome. Methods Senventy patients with unilateral carpal tunnel syndrome were randomly divided into REMIR group and open procedure group ,with 35 cases in each group. Kelly＇s standard, two-point discrimination, operation time and complication occurrence were compared between the two groups. Results All patients were followed-up for I2 months. There was no significant difference in the therapeutic results and in the improvement of two-point discrimination between the two groups （P 〉 0.05 ）. The operation time of REMIR group was significantly shorter than the open procedure group （ [ 10. 03 ± 1.84 ] min vs [ 37. 63 ± 7. 18 ] min, t = 22. 210, P 〈 0. 001 ）. And there was no cases with Scar tenderness in REMIR group while there was 7 cases in open procedure group. Condusion Compared with the open procedure,the REMIR method has the same clinical efficacy while with the advantages of causing smaller skin scar and being less time consuming.