腕管综合征复发7例分析

Recurrence of 7 Cases of Carpal Tunnel Syndrome

目的总结7例小切口手术治疗腕管综合征复发病例的诊治过程,为临床提供治疗经验。方法2012年1月至2019年12月,对已在外院经临床和电生理确诊为腕管综合征且行小切口手术治疗后复发的7例病人进行二次常规手术切口治疗。术中探查发现7例腕管内均有白色粉末状物沉积,给予腕管内病灶清除及彻底松解正中神经。根据顾玉东推荐的腕管综合征功能评定标准评估疗效。结果术后随访6~18个月,平均12个月。术后正中神经支配区麻木症状较术前好转,夜间麻醒消失,按照顾玉东的腕管综合征功能评定标准评定:优5例,良2例。结论小切口治疗腕管综合征需排除痛风石病因可能,对于可疑病例手术治疗需进行常规切口手术。

Objective To summarize the diagnosis and treatment of 7 cases of recurrence of carpal tunnel syndrome treated with small incision,and to provide clinical treatment experience.Methods Between January 2012 and December 2019,7 cases of recurrent carpal tunnel syndrome confirmed clinically and electrophysiologically and treated with small incision surgery in other hospitals were given the secondary conventional incision treatment in our hospital.White powder deposits were found in the carpal tunnel of 7 cases,the lesions in the carpal tunnel were cleared and the median nerve was completely released.Gu Yudong’s functional evaluation criteria of carpal tunnel syndrome were used to comprehensively judge the effect of surgical treatment.Results The patients were followed up for 6-18 months(mean 12 months).Postoperative numbness in the median nerve innervation area was alleviated as compared with that before surgery,and numbness at night disappeared.According to Gu Yudong’s functional evaluation criteria of carpal tunnel syndrome,effectiveness was excellent in 5 cases and good in 2 cases.Conclusion Small incision treatment of carpal tunnel syndrome needs to exclude the possible etiology of gout stones,and conventional incision is necessary for the surgical treatment of suspicious cases.