肘管综合征的治疗研究进展

PROGRESS OF TREATMENT OF CUBITAL TUNNEL SYNDROME

目的对肘管综合征(cubital tunnel syndrome,CTS)的治疗研究进展进行综述。方法广泛查阅近年国内外与CTS治疗相关的文献,并进行总结分析。结果 CTS是临床上常见的周围神经卡压病变之一,临床表现为环指与小指麻木和刺痛感、肘部疼痛以及肘关节长时间弯曲后感觉改变,严重时也可发生手内在肌萎缩、肌力减退、爪形手畸形等。其病因包括各种解剖结构异常导致的尺神经卡压以及肘部外伤后引起的尺神经麻痹等。CTS的治疗方式包括非手术治疗和手术治疗。其中手术治疗包括原位松解术、尺神经前置术、肱骨内上髁切除术和内窥镜下尺神经松解术等。结论 CTS的治疗方式多种多样,但其适应证和疗效仍不确切,需要更深入研究,以形成一套公认的治疗体系。

Objective To review the current progress of treatment of cubital tunnel syndrome （CTS）. Methods Recent relevant literature on the treatment of CTS was extensively reviewed and summarized. Results CTS is one of the most common peripheral nerve compression diseases. The clinical presentations of CTS consist of numbness and tingling in the ring and small fingers of the hand, pain in the elbow and sensory change following long-time elbow bending. Severe symptoms such as weakness or atrophy of intrinsic muscles of the hand and claw hand deformity may occur. The etiology of CTS is ulnar nerve compression caused by morphological abnormalities and nerve paralysis after elbow trauma. CTS can be treated by nonsurgical methods and surgery. Surgical options include in situ decompression, ulnar nerve transposition, medial epicondylectomy, and endoscopic release. Conclusion There are multiple options to treat CTS, but the indication and effectiveness of each treatment are still controversial. Further studies are required to form a generally accepted treatment system.