开放式腕管切开松解减压联合正中神经返支探查松解术治疗重度腕管综合征的疗效

Clinical outcomes of open carpal tunnel release combined with recurrent branch release of median nerve in treating severe carpal tunnel syndrome

目的比较开放式腕管切开松解减压联合正中神经返支探查松解术与单纯小切口手术治疗重度腕管综合征的疗效。方法重度腕管综合征患者46例均分为两组:A组采用开放式腕管切开松解减压联合正中神经返支探查松解术治疗;B组采用单纯小切口手术治疗。比较两组的手术、住院时间及术后瘢痕痛发生率。于术后3个月及术后1年采用Kelly评级法评估手术效果。结果 A组的手术时间长于B组[(35.1±5.3)min vs.(16.7±3.1)min](P<0.05)。A组术后3个月及1年的优良率分别为78.26%和86.96%,高于B组60.87%和73.91%(P<0.05)。术后3个月,A组瘢痕痛发生率高于B组(30.43%vs.13.04%)(P<0.05);但术后1年,两组瘢痕痛发生率相仿(8.70%vs.4.35%)(P>0.05)。结论开放式腕管切开松解减压联合正中神经返支探查松解术治疗重度腕管综合征具有较好的疗效。

Objective To compare the clinical outcomes of open carpal tunnel release combined with recurrent branch release of the median nerve in the treatment of severe carpal tunnel syndrome （CTS） .Methods A total of 46 patients with severe CTS was treated with open carpal tunnel release combined with recurrent branch release of the median nerve （group A ,23 cases） or minimal incision carpal tunnel release（group B ,23 cases） .The operation time ,hospital stay and incidence of scar pain were compared between two groups .Surgical outcomes were evaluated by Kelly standard in 3 months and one year after operation .Results The operation time was longer in group A than that in group B [（35.1 ± 5.3） min vs .（16.7 ± 3.1） min]（P〈0 .05） .The fineness rates in 3 months and one year after operation were higher in group A than those in group B （70.86% vs .60.87% and 86.96% vs . 73.91% ）（P〈0 .05） .The incidence rate of scar pain in 3 months was higher in group A than that in group B（30.43% vs .13.04% ） （ P〈0 .05 ） ,which in one year was not significantly different between two groups（8.70% vs .4.35% ）（P〉0 .05） .Conclusion Open carpal tunnel release combined with recurrent branch release of the median nerve has better clinical efficacy in the treatment of severe CTS .