超声引导下针刀松解腕横韧带联合神经阻滞治疗腕管综合征疗效观察

The clinical effect observation of ultrasound-guided needle knife release of transverse carpal ligament combined with nerve block in the treatment of carpal tunnel syndrome

目的探讨超声引导下针刀松解腕横韧带联合正中神经阻滞治疗腕管综合征(GTS)的临床疗效。方法28例患者36个腕关节在超声引导下行针刀松解腕横韧带联合腕管内正中神经阻滞治疗。于术后1 w、4 w、12 w时对患者的临床疗效进行评价。结果36个腕关节术后均未见肌腱、血管及神经损伤等并发症。SNCV、SNAP、DML、CMAP术后1 w、4 w时与术前比较,差异无统计学意义(P>0.05);术后12 w时与术前比较,差异有统计学意义(P<0.01)。术后12 w时36个腕关节临床疗效评价优21个,良9个,一般4个,差2个,优良率为83.3%。结论超声引导针刀松解腕横韧带联合正中神经阻滞治疗轻中度CTS精准、安全,疗效确切,值得临床推广应用。

Objective To explore the clinical effect of ultrasound-guided needle knife release of transverse carpal ligament combined with median nerve block in the treatment of carpal tunnel syndrome.Methods 28 patients with 36 wrist joints were treated by ultrasound-guided needle knife release of transverse carpal ligament combined with median nerve block in carpal tunnel.The clinical efficacy was evaluated at 1 w,4 w and 12 w after operation.Results No complications such as tendon,vessel and nerve injury were found in 36 wrist joints.There was no significant difference in SNCV,SNAP,DML and CMAP at 1 w and 4 w after operation(P>0.05),but there was significant difference at 12 weeks after operation(P<0.01).12 weeks after operation,the clinical efficacy of 36 wrist joints was evaluated as excellent in 21 cases,good in 9 cases,fair in 4 cases and poor in 2 cases.The excellent and good rate was 83.3%.Conclusion Ultrasound-guided needle knife release of transverse carpal ligament combined with median nerve block in the treatment of mild to moderate CTS is accurate,safe and effective,which is worthy of clinical application.