腕部与手掌部小切口治疗腕管综合征的Meta分析

A meta-analysis of clinical outcomes of limited wrist invasion versus limited palmar invasion for the treatment of carpal tunnel syndrome

目的运用循证医学的方法,对腕部与手掌部小切口腕管松解术治疗腕管综合征的疗效进行系统评价。方法计算机检索Pubmed、Cochrane图书馆、EMBASE、CBM、CNKI、万方数据库,时间自建库起至2018年3月,并查阅相关参考文献。收集所有相关的随机对照试验,并评价纳入研究的方法学质量,采用Revman5.3软件进行Meta分析,以获得经腕部与手掌部小切口行腕管松解术治疗腕管综合征的疗效是否有差异的相关证据。结果共纳入5个随机对照试验进行评价。Meta分析显示,腕部小切口组和手掌部小切口组在BCTQ术后症状评分和手术时间差异无统计学意义(P>0.05);腕部小切口组在BCTQ术后功能评分和瘢痕不适发生率优于手掌部小切口组,差异有统计学意义(P<0.05)。结论与手掌部小切口组相比,腕部小切口组在促进术后功能恢复和降低瘢痕不适发生率方面有一定的优势,但仍需要大样本的高质量随机对照试验来验证此次分析结果。

ObjectiveTo evaluate the efficacy of carpal tunnel release with small incision in wrist and palm for the treatment of carpal tunnel syndrome using evidence-based medicine method.MethodsPubMed,Cochrane Library,EMBASE,CBM,CNKI and Wanfang databases were searched by computer for relevant studies from their establishment to March 2018.References of relevant articles were checked for additional articles.All relevant randomized controlled trials were collected and the methodological quality of the included studies was evaluated.Revman 5.3 software was used for meta-analysis to obtain the evidence of differences in the efficacy of carpal tunnel release through wrist and palm incisions in the treatment of carpal tunnel syndrome.ResultsFive randomized controlled trials were included for evaluation.Meta-analysis showed that there was no significant difference in BCTQ postoperative symptom score and operation time between wrist incision group and palm incision group(P>0.05).The BCTQ postoperative functional score and incidence of scar discomfort in wrist incision group were better than those in palm incision group(P<0.05).ConclusionCompared with the palm incision group,the wrist incision group has some advantages in promoting functional recovery and reducing the incidence of scar discomfort,but it still needs a large sample of high-quality randomized controlled trials to verify the results of this analysis.