小切口治疗腕管综合征临床疗效观察

Clinnical effect observation of small incision in the treatment of carpal tunnel syndrome

目的探讨小切口治疗腕管综合征的临床效果。方法从2011年7月-2014年7月吉林省人民医院收治掌部腕管综合征的患者中选取典型患者42例（45侧），采用掌部小切口切断腕横韧带的治疗方法，术后进行随访，使用GSS评分对术前以及术后6个月患者功能恢复情况进行评估。结果排除2例（3侧）患者术中发现腕管内囊肿，改为传统切口手术，其余40例（42侧）患者手术均获得了成功，并且在术后没有出现并发症。采用GSS评分标准对术前和术后6个月患者疼痛、麻木感、夜醒、肌力减退、手指末端神经异感及总分进行评估[（5．65±0．89）、（3．79±1．06）、（2．67±0．67）、（4．49±0．95）、（3．35±0．78）、（20．10±4．65）比（0．94±0．50）、（0．86±0．35）、（O．35±0．09）、（1．00±0．40）、（O．46±0．20）、（3．61±0．06）分]，术后随访评估分数较术前明显减低，差异有统计学意义（P〈0．05）。结论小切口法治疗腕管综合征是一种效安全的手术方法，其具有手术时间相对较短、预后疗效比较好、并发症较少等优点，值得在临床应用和推广。

Objective To discuss the clinical effect of small incision in the treatment of carpal tunnel syndrome. Methods From July 2011 to July 2014 in Jilin Province People＇ Hospital 42 patients （45 sides） with metacarpus carpal tunnel syndrome were selected. All patients were given small incision of wrist transverse ligament surgery and followed up for 6 months. Functional recovery was evaluated by GSS standard. Results 2 cases （3 sides） were found cyst in wrist, given traditional incision surgery instead. Surgery of the other 40 cases （42 sides） were successful, and no complication happened. The pain, feeling of numbness, night waking, muscle loss, the end of finger abnormal feeling, and total scores in GSS scores after surgery were lower than those before surgery [（5.65±0.89）, （3.79±1.06）, （2.67±0.67）, （4.49±0.95）, （3.35±0.78）, （20.10±4.65）vs （0.94±0.50）, （0.86±0.35）, （0.35±0.09）, （1.00±0.40）, （0.46±0.20）, （3.61±0.06） scores], the differences were statistically significant （P 〈 0.05）. Conclusion Small incision in the treatment of carpal tunnel syndrome is an effective safe surgical method, it has advantages of relatively short operating time, better curative effect and prognosis, less complications, and it is worth in the clinical application and promotion.