痛风引起腕管综合征诊疗的临床研究

A clinical study on diagnosis and treatment of carpal tunnel syndrome caused by gout

[目的]探讨痛风引起的腕管综合征[痛风性腕管综合征(carpal tunnel syndrome, CTS)]的发病率、诊治方案及手术疗效。[方法]回顾2016年1月~2019年12月佛山市中医院修复重建外科手术治疗的252名腕管综合征患者的临床资料,其中男72例,女80例,平均年龄(53.50±10.04)岁,均采用手术治疗,统计痛风性CTS的发病率,观察治疗效果。[结果]痛风性CTS共16例,占比6.35%,全部为男性;全部病例均清理了痛风结石,解除腕管内正中神经卡压,手指麻木症状好转,皮肤无坏死,伤口均Ⅰ期愈合。术后随访6个月~3年,平均(15.64±2.76)个月,未见患肢腕管综合征复发,腕部及手部外形及功能满意。[结论]痛风石沉积累及正中神经可引起腕管综合征,及早的手术治疗可明显改善正中神经功能及屈伸指功能。

[Objective] To investigate the incidence, diagnosis and surgical efficacy of carpal tunnel syndrome caused by gout(gouty CTS). [Methods] A retrospective study was conducted on 252 patients who were surgially treated in Foshan Hospital of Traditional Chinese Medicine from January 2016 to December 2019 for carpal tunnel syndrome. There were 72 male and 80 female, with an average age of(53.50±10.04) years. All patients received surgical treatment, and gouty CTS was observed to analyze the treatment effect. [Results] Among the 252 patients, 16 patients were of gouty CTS, accounting for 6.35%, who were all male. All the patients received surgical removal of gout stones to relieve compression on the median nerve in the carpal tunnel. The numbness of the fingers significantly improved without skin necrosis, and the incision got primary healing after operation. The postoperative follow-up lasted for 6 months to 3 years with an average of(15.64±2.76) months. There was no recurrence of carpal tunnel syndrome in the affected limb. The appearance and function of the wrist and hand were satisfactory. [Conclusion] Accumulation of gouty tophi on median nerve does cause carpal tunnel syndrome, and early surgical treatment can significantly improve median nerve function and flexion and extension functions.