应用腕掌尺侧横切口松解减压术治疗腕管综合征

Application of proximal wrist incision decompression and reduction treatment for carpal tunnel syndrome

目的报道应用腕掌尺侧横切口行切开松解减压术治疗腕管综合征的方法及其疗效。方法2010年1月-2014年12月，采取腕掌尺侧横切口，切开松解减压术治疗腕管综合征30例（34侧）。术后随访疼痛、麻木等感觉及手内在肌肌力评估。结果所有患者术后第1天夜间麻醒症状消失，自我感觉满意。手术2周拆线后即恢复正常生活和工作。其中28例经术后9个月以上随访，2例失访。随访期间症状均消失，拇短展肌肌萎缩明显改善，拇外展力量增强。本组患者术后未见有腕掌部瘢痕痛，无神经及血管损伤等并发症发生。结论腕掌尺侧横切口，微创腕管切开松解术是一种微创、安全、简便和有效的腕管手术，但由于它并不适合所有的患者，临床上必须针对腕管中正中神经卡压的具体情况选择合适的适应证。

Objective To report the use of wrist ulnar neurolysis of transverse incision decompression in the treatment of carpal tunnel syndrome and its treatment method. Methods From January 2010 to December 2014 take wrist palmar ulnar transverse incision of neurolysis of decompression for the treatment of carpal tube syndrome in 30 cases （34 sides）. Postoperative follow up included pain, numbness and other sensory and hand intrinsic muscle strength evaluation. Results All the patients were satisfied with the symptoms of first days after operation. The restoration of normal life and work 2 weeks after operation. Among the 28 patients, 9 patients were followed up for months or more, and 2 patients were lost to follow-up. During the follow-up, the symptoms disappeared, the abductor pollicis brevis muscle atrophy significantly improved thumb abductor strength. All patients had no pain without the wrist and palm scar, nerve and vascular injury and other complications. Conclusion Wrist palmar ulnar small transverse incision minimally invasive wrist tube cut loose solution procedure is a minimally invasive, safe, simple and effective operation, but because it is not suitable for all patients, we should choose suitable treatment for tunnel CKS nerve entrapment in the specific situation to choose suitable indications.