内镜辅助尺神经前置术治疗肘管综合征的疗效随访

The outcome of anterior transposition of the ulnar nerve in treatment of cubital tunnel syndrome with endoscopically assisted

目的探讨内镜辅助下尺神经松解皮下前置治疗肘管综合征的临床疗效。方法2008年2月至2010年6月，共收治肘管综合征患者44例，均行尺神经松解皮下前置术治疗，其中行开放性肘管切开手术28例，内镜下手术16例。对比两组手术时间、术后用药情况、创口瘢痕长度、术后住院时间。术后随访1—12个月，观察术后工作恢复时间并评价尺神经功能。结果内镜组平均手术时间（67．20±19．69）min，术后瘢痕长（1．50±O．58）cm，术后止痛药使用率6．3％，术后平均住院时间（2．40±1．42）d，平均恢复工作时间（14．60±4．69）d；开放组平均手术时间（62．80±11．06）min，术后瘢痕长（8．70±1．42）cm，术后止痛药使用率42．8％，平均住院时间（5．70±2．53）d，平均恢复工作时间（29．40±8．75）d，两组差异均有统计学意义（均为P〈0．05）。按中华手外科学会周围神经功能评定标准，术后12个月．尺神经功能评分：开放组优良率82．14％，内镜组优良率81．25％，差异无统计学意义（P〉0．05）。结论内镜组具有皮肤切口小、组织创伤轻、并发症少、术后疼痛轻，早期恢复日常工作等优点．且能获得与开放肘管切开尺神经松解皮下前置术相同的疗效。

Objective To investigate the outcome between endoseopieally assisted and routine anterior transposition of the ulnar nerve for treatment of eubital tunnel syndrome. Methods From Februray 2008 to June 2010, forty-four patients with eubital tunnel syndrome were treated with routine anterior subcutaneous transposition （routine group, 28 eases） and endoseopieally assisted anterior subcutaneous transposition （endoscope group, 16 eases）. The operate time, drug administration, sear and postoperative hospital stay were compared. The patients were followed 1-12 month postoperatively, postoperative time back to work and function of ulner nerve were recorded. Results The results of endoscope group were as follows： operative time was （67.20 ± 19.69）min; postoperative scar length was （1.5% ± 0.58） em; rate of administration of anodyne was 6.3%; postoperative hospital stay was （2.4% ± 1.42） days; postoperative time back to work, （14.6 ± 4.69） days; the results of open surgery group were as follows： operative time （62.8% ± 11.06） min; postoperative scar length was （8.7% ±1.42） em; rate of administration of anodyne was 42.8%; postoperative hospital stay was （5.7% ± 2.53） days; postoperative time back to work was （29.40 ±8.75） days; all differences of the re- sults were significant between two groups （P 〈 0.05）. According to function of ulner nerve scoring system, one year postoperatively, excellent or good results were 82.14% in routine group and 81.25% in endoscope group, no significant difference between two groups （P 〉 0.05）. Conclusion Compared with routine anterior transposition of the ulnar nerve, endoseopically assisted anterior transposition has the following advantages： smaller incision and less tissue damage, less postoperative pain and sooner returning to work. And similar outcome was achieved from the two group.