腕横韧带重建术在腕管综合征患者中的疗效及对握力恢复和上肢功能障碍评分的影响

Effect of transverse carpal ligament reconstruction in patients with carpal tunnel syndrome and its effect on grip strength recovery and disability arm shoulder hand score

目的探究腕横韧带重建术在腕管综合征患者中的临床疗效。方法选取2010年3月至2020年3月本院收治的30例腕管综合征患者作为研究对象,按照随机数字表法分为对照组和观察组,每组15例。对照组采用传统腕管切开减压方式治疗,观察组采用腕横韧带重建术治疗,比较两组临床疗效、患肢正中神经运动神经潜伏期(DML)、两点辨别觉(TPD)、握力、上肢功能障碍(DASH)评分及手术相关指标。结果观察组总优良率为93.33%,高于对照组的53.33%,差异有统计学意义(P<0.05);术前、术后1个月,两组握力值、DML、TPD、DASH评分比较差异无统计学意义;术后3、6个月,两组DML、TPD比较差异无统计学意义,观察组握力值高于对照组,DASH评分低于对照组,差异有统计学意义(P<0.05);术后1、3、6个月,两组握力值、DML、TPD、DASH评分与术前比较差异均有统计学意义(P<0.05);观察组切口长度、手术时间和住院时间均短于对照组,差异有统计学意义(P<0.05)。结论腕横韧带重建术治疗腕管综合征患者效果显著,可改善患者握力值、DML、TPD、DASH评分,缩短治疗时间,值得临床推广应用。

Objective To explore the clinical effect of reconstruction of the transverse carpal ligament in patients with carpal tunnel syndrome.Methods 30 patients with carpal tunnel syndrome admitted to our hospital from March 2010 to March 2020 were selected as the research subjects,and they were divided into control group and observation group according to random number table method,with 15 cases in each group.The control group was treated with traditional carpal tunnel decompression,and the observation group was treated with transverse carpal ligament reconstruction.The clinical effects,distal motor latency(DML)of the affected limb,two-point discrimination(TPD),grip strength,disability arm shoulder hand(DASH),and operatively related indexes were compared between the two groups.Results The total excellent and good rate of observation group was 93.33%,which was higher than 53.33% of control group,the difference was statistically significant(P<0.05).Before and 1 month after surgery,there were no significant differences in grip strength,DML,TPD and DASH scores between the two groups;3 and 6 months after surgery,there were no significant differences in DML and TPD between the two groups,while the grip strength of the observation group were higher than that of the control group,the DASH scores was lower than control group,the difference was statistically significant(P<0.05);1,3 and 6 months after surgery,the differences in grip strength,DML,TPD and DASH scores between the two groups were statistically significant compared with those before surgery(P<0.05);the incision length,operation time and hospitalization time in the observation group were shorter than those in the control group,the difference was statistically significant(P<0.05).Conclusion Transcarpal carpal ligament reconstruction has significant effect in the treatment of patients with carpal tunnel syndrome.it can improve the patients'grip strength,DML,TPD,and DASH scores,and shorten the treatment time,it is worthy of clinical application.