超声引导下运用不同小针刀手法治疗腕管综合征26例

Treatment of Twenty-Six Cases of Carpal Tunnel Syndrome with Different Small Needle-Knife Manipulations Under Ultrasound Guidance

目的:观察超声引导下运用不同小针刀手法治疗腕管综合征(carpal tunnel syndrome,CTS)的临床疗效,探究不同小针刀手法对减轻正中神经受压程度的影响。方法:将52例CTS患者按照随机数字表法分为A组和B组,每组26例。两组患者分别实施不同的小针刀手法,A组使用提插手法,B组使用纵运手法。观察两组治疗前后Levine腕管综合征问卷评分、感觉神经传导速度(sensory nerve conduction velocity,SCV)及运动神经传导速度(motor nerve conduction velocity,MCV)变化情况。结果:两组患者治疗前levine腕管综合征患者问卷调查评分比较,差异无统计学意义(P>0.05),治疗28 d后结局指标比较,差异有统计学意义(P<0.05);两组治疗后正中神经电生理参数MCV及SCV比较,差异有统计学意义(P<0.05),且B组正中神经电生理参数MCV及SCV平均值均明显优于A组。结论:在超声引导下运用小针刀治疗腕管综合征,选用小针刀纵运手法比提插手法更能减轻正中神经的受压。

Objective:To observe the clinical curative effect of different small needle-knife manipulations under ultrasound guidance in the treatment of carpal tunnel syndrome(CTS),and to explore the influence on reducing the compression of median nerve.Methods:A total of 52 patients with CTS were randomly divided into group A and group B,with 26 cases in each group.The patients in the two groups were treated with different small needle-knife manipulations.Group A used lifting and thrusting manipulation and group B used longitudinal manipulation.The changes of Levine CTS questionnaire score,sensory nerve conduction velocity(SCV) and motor nerve conduction velocity(MCV) before and after treatment were observed in the two groups.Results:There was no significant difference between the two groups in the questionnaire scores of Levine CTS before treatment(P>0.05),but there was significant difference in the outcome indexes after 28 days of treatment(P<0.05).There were significant differences in median nerve electrophysiological parameters MCV and SCV between the two groups after treatment(P<0.05),and the average values of median nerve electrophysiological parameters MCV and SCV in group B were significantly better than those in group A.Conclusion:In the treatment of CTS with small needle-knife therapy under ultrasound guidance,the longitudinal manipulation of small needle-knife therapy can reduce the compression of median nerve better than lifting and thrusting manipulation does.