腕关节外固定支具联合复方倍他米松、甲钴胺治疗腕管综合征的临床疗效

Clinical efficacy analysis of wrist joint external fixation brace combined with compound betamethasone and mecobalamin in the treatment of carpal tunnel syndrome

目的:分析腕关节外固定支具联合复方倍他米松、甲钴胺治疗对腕管综合征(CTS)患者的临床疗效、Boston腕管问卷调查评分(BTCQ)及生活质量的影响。方法:回顾性收集2019年1月—2020年1月我院收治的201例CTS患者的临床资料。所有患者均佩戴腕关节外固定支具,其中A组联合复方倍他米松注射液1 mL(52例)、B组予甲钴胺注射液0.5 mg(68例),C组予复方倍他米松1 m L联合甲钴胺0.5 mg(81例)。对比3组治疗后3周的临床疗效、电生理指标改变情况、疼痛情况、症状缓解时间、BTCQ、生活质量以及不良反应。结果:C组总有效率为97.53%,明显高于A组(76.92%)、B组(72.06%),差异有统计学意义(P<0.05)。A、B组治疗后疼痛及麻木缓解时间、电生理指标及VAS评分比较,均无明显差异(P>0.05),治疗后3组患者感觉神经传导速度(SCV)、运动神经传导速度(MCV)、肌肉动作电位(CMAP)值均升高,正中神经末端运动潜伏期(DML)值均降低,C组SCV、MCV、CMAP值均高于A、B组,DML值低于A、B组(P<0.05);3组治疗后视觉模拟疼痛评分(VAS)出现降低,C组VAS评分明显低于A、B组(P<0.05);C组疼痛及麻木缓解时间明显短于A、B组(P<0.05);治疗后,C组BTCQ明显低于A、B组,生理综合向量(PCS)、心理综合向量(MCS)评分则高于A、B组(P<0.05),A、B组治疗后BTCQ、PCS、MCS评分比较均无差异(P>0.05);3组均未出现严重不良反应,A组不良反应总发生率为1.92%、B组为2.94%、C组为4.93%,3组比较差异无统计学意义(P>0.05)。结论:腕关节外固定支具联合复方倍他米松、甲钴胺治疗CTS可提高患者治疗效果,改善腕功能,提高患者生活质量。

Objective To analyze the effects of external wrist fixation brace combined with compound betamethasone and methylcobalamin on the clinical efficacy,Boston carpal tunnel questionnaire(BTCQ)and quality of life of carpal tunnel syndrome(CTS).Methods Clinical data of 201 CTS patients admitted to our hospital from January 2019 to January 2020 were retrospectively collected.All patients were equipped with wrist joint external fixators,including group A combined with 1mL of compound betamethasone injection(52 cases),group B with 0.5 mg of mecobalamine injection(68 cases),and group C combined with 1mL of compound betamethasone injection and 0.5 mg of mecobalamine(81 cases).Compare the clinical efficacy,changes in electrophysiological indicators,pain status,symptom relief time,BTCQ,quality of life,and adverse reactions of the three groups after 3 weeks of treatment.Results There were differences in the comparison of clinical efficacy among the three groups,and the total effective rate in group C was 97.53%,which was significantly higher than that in group A(76.92%)and group B(72.06%)(<0.05).there was no significant difference in the comparison of pain and numbness relief time,electrophysiological indexes and VAS scores in groups A and B after treatment(>0.05).the SCV,MCV and CMAP values increased in all three groups after treatment.The SCV,MCV and CMAP values were higher in group C than in groups A and B,and the DML values were lower than in groups A and B(<0.05);VAS treatment,and VAS scores in group C were significantly lower than in groups A and B(<0.05);pain and numbness relief time was significantly shorter in group C than in groups A and B(<0.05);after treatment,BTCQ in group C was significantly was significantly lower in group C than in groups A and B,while PCS and MCS scores were higher than in groups A and B(<0.05),and there was no difference in BTCQ,PCS and MCS scores after treatment in groups A and B(>0.05);no serious adverse reactions occurred in all three groups,and the total incidence of adverse reactions was 1.92%in group A,2.94%in group B,and 4.93%in group C.The difference between the three groups was not statistically significant(>0.05).Conclusion The combination of external wrist fixation brace with compound betamethasone and methylcobalamin for CTS can improve the treatment effect of patients,improve wrist function and improve the quality of life of patients.