尺神经骨膜外前置术与单纯尺神经松解前置术治疗肘管综合征的疗效分析

Curative Effect Analysis of External Ulnar Nerve Periosteal Transposition Surgery and Simple Ulnar Nerve Release Transposition Surgery in Treatment of Cubital Tunnel Syndrome

目的 分析尺神经骨膜外前置术与单纯尺神经松解前置术治疗肘管综合征的临床效果。方法 选取2020年1月-2022年12月本院收治的52例肘管综合征患者,按照随机数字表法分为对照组(n=26,单纯尺神经松解前置术治疗)和观察组(n=26,尺神经骨膜外前置术治疗),对比两组肌电图指标[尺神经传导速度(NCV)、患侧小指展肌复合肌肉动作电位波幅(CMAP)、运动电位潜伏期(MEPLP)]、手肌力、感觉功能指标以及多维行为评定量表(DASH)评分、临床疗效。结果 治疗前两组肌电图指标无差异(P>0.05);治疗后观察组NCV、CMAP高于对照组,MEPLP低于对照组(P<0.05)。治疗前两组手肌力以及感觉功能评分无差异(P>0.05);治疗后观察组握力、拇指和小指握力、拇指和环指捏力高于对照组,DASH评分低于对照组(P<0.05);观察组临床疗效高于对照组,差异有统计学意义(P<0.05)。结论 对肘管综合征患者实施尺神经骨膜外前置术治疗,可以有效改善患者功能,加快患肢神经功能修复,临床效果优于单纯尺神经松解前置术手术治疗,值得推广。

Objective To analyze clinical effect of external ulnar nerve periosteal transposition surgery and simple ulnar nerve release transposition surgery in treatment of cubital tunnel syndrome.Methods The paper chose 52 patients with cubital tunnel syndrome admitted to our hospital from January 2020 to December 2022,and divided them into control group(n=26,with simple ulnar nerve relaxation and preposition)and observation group(n=26,with preposition of ulnar nerve outside the periosteum)randomly.Electromyography indicators,hand grip strength,sensory function indicators,DASH scores and clinical effect were compared between two groups.Results There was no difference in electromyography between two groups before treatment(P>0.05).After treatment,the NCV and CMAP levels in observation group were higher than control group,while the MEPLP levels were lower than control group(P<0.05).There was no difference in hand muscle strength and sensory function scores between two groups before treatment(P>0.05).After treatment,the grip strength,thumb and little finger grip strength,thumb and ring finger grip strength of observation group was higher than control group and the DASH scores were lower than control group(P<0.05).Clinical effect of observation group(100.00%)was higher than control group(73.08%),with statistically significant difference(P<0.05).Conclusion Extraperiosteal anterior transposition of ulnar nerve can improve function and accelerate repair of affected limb nerve function of of cubital tunnel syndrome patients effectively,with higher clinical effect than simple ulnar nerve release and anterior transposition surgery,which is worthy of promotion.