双孔内窥镜与改良小切口治疗腕管综合征的临床随机对照研究

Clinical effect comparison between 2-portal endoscopic surgery and modified mini-incision surgery on carpal tunnel syndrome

目的对比分析双孔内窥镜与改良小切口治疗腕管综合征分别在围手术期及术后康复期功能恢复情况及相关临床指标,归纳总结其治疗效果。方法2019年5月-2021年5月,采用单中心随机盲法临床试验,行双孔内窥镜下腕横韧带松解术和改良有限小切口微创松解术治疗腕管综合征59例,并记录患者术后不同时期的症状及生活改善程度,进行定性、定量的对比分析,并通过手术费用、住院时间、恢复时间等随访资料评价双孔内窥镜与改良小切口微创技术在治疗腕管综合征各方面的优劣。结果两种治疗方法对腕管综合征远期疗效一致,但手术费用、住院时间、术后短期症状缓解方面,改良小切口有优势;在手术瘢痕、切口疼痛方面内窥镜下腕横韧带松解术更有优势。结论双孔内窥镜与改良小切口治疗腕管综合征,两种疗效远期效果一致,但在术后康复及手术费用及时间等各方面,各有利弊,针对不同患者,应根据医疗机构实际条件和具体情况,选择合适手术方式。

Objective Comparing the effect of 2-portal endoscopic surgery and modified mini-incision surgery on carpal tunnel syndrome in perioperative period and rehabilitation period.Methods Using a single-center randomized double-blind control clinical trial,treating carpal tunnel syndrome patients sing the 2-portal endoscopic surgery and modified mini-incision surgery.Obtaining complete follow-up data including the severity of symptom,living quality,surgery time,surgery cost,and back to life time,evaluating the effect of each technique.Results Long-term effect of the two surgery techniques showed no difference.The surgery time,surgery cost and short-term effect of the mini-incision group was greater than the endoscopic group.The endoscopic group showed better result in scar and post-operative pain during 1 week to 1 month period.Conclusion Long-term effect of the two surgery techniques showed no difference,but each has its own advantages and disadvantages in post-operative rehabilitation,surgery cost and surgery time.We should choose proper surgery technique basing on different situation of the medical center and patients to benefit patients most.