自制开窗式透明通道内镜下腕横韧带松解术治疗腕管综合征

Treatment of carpal tunnel syndrome with self-made open-window transparent channel endoscopic transversal ligament release

目的探讨使用一次性吸引连接管自制成开窗式透明的手术通道,内镜下行腕横韧带松解术治疗腕管综合征的临床疗效。方法2018年1月-2020年7月治疗非继发性腕管综合征15例(18侧),均采用自制开窗式透明通道内镜下行腕横韧带松解术,通道材料是一条透明的长16.0 cm、管内径为4.0 mm的一次性吸引连接管,在其中间切开一个底边为1.0 mm、腰为2.0 mm的等腰三角形窗口,窗口用于放置钩刀,在腕横纹及手掌各作长8.0~10.0 mm小切口,在腕管内建立透明通道,在内镜直视下行腕横韧带松解。结果术后15例(18侧)腕管综合征患者无血管神经肌腱损伤并发症,术后患者均诉手指麻痛感症状明显改善,随访3~6个月。14例(17侧)手指感觉完全恢复;1例仅中指末节指腹感觉麻木,但较术前明显减轻;5例大鱼际肌中度萎缩患者,肌萎缩程度明显减轻,拇指对掌功能已恢复正常。结论自制开窗式透明通道内镜下行腕横韧带松解术治疗腕管综合征是一种安全有效、实用性强,适合基层医院开展的好方法。

Objective To investigate the clinical efficacy and practicability of endoscopic transverse wrist ligament release in the treatment of carpal tunnel syndrome by using disposable suction connecting tube to make a window-opening transparent surgical channel.Methods From January 2018 to July 2020,our hospital treated 15 cases of non-secondary carpal tunnel syndrome(18 sides),All of them were treated by self-made open-window transparent channel endoscopic wrist transverse ligament release,The channel material is a transparent one-time suction connecting pipe with a length of 16 cm、and a diameter of 4 mm,to cut open an isosceles triangle window with a base of 1 mm、and a waist of 2 mm,window for hook knives,Small incisions of about 8~10 mm each across the wrist and palm,To establish a clear passage through the carpal tunnel,Transverse carpal ligament release under endoscopy.Results After operation,15 patients(18 sides)with carpal tunnel syndrome had no complications of vascular nerve tendon injury.After 3~6 months of follow-up,14 patients(17 sides)had complete recovery of finger sensation,and 1 case had only middle finger end finger abdominal numbness,but less than before.Conclusion It is a safe,effective and practical method for the treatment of carpal tunnel syndrome by self-made window-opening transparent channel endoscopic wrist transverse ligament release.