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的效果探讨

Effect of ultrasound-guided needle knife release of transverse carpal ligament combined with median nerve block in the treatment of carpal tunnel syndrome

目的 观察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(CTS)的临床效果。方法 选择30例CTS患者,随机分为观察组和对照组,各15例。对照组采用超声引导下针刀单纯松解腕横韧带治疗,观察组在对照组基础上联合正中神经阻滞治疗。比较两组治疗效果及治疗前后基因组瘢痕评分(GSS评分)。结果 观察组治疗优良率为93.33%,高于对照组的60.00%(P<0.05)。治疗前,两组疼痛、麻木感、夜间疼醒次数、感觉异常、肌力减退评分及总分比较无统计学意义(P>0.05);治疗后3个月,两组疼痛、麻木感、夜间疼醒次数、感觉异常、肌力减退评分及总分均低于治疗前,且观察组疼痛评分(0.80±0.56)分、麻木感评分(0.67±0.72)分、夜间疼醒次数评分(0.40±0.51)分、感觉异常评分(0.67±0.61)分、肌力减退评分(1.07±0.46)分及总分(3.61±1.96)分均低于对照组的(2.07±1.03)、(1.47±0.92)、(1.07±0.70)、(1.87±0.74)、(1.80±0.68)、(8.28±2.79)分(P<0.05)。结论 超声引导下针刀松解腕横韧带联合正中神经阻滞治疗CTS效果显著,对改善患者临床症状优势明显,临床上值得推广。

Objective To observe 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(CTS).Methods 30 patients with CTS were randomly divided into an observation group and a control group,each with 15 cases.The control group used needle knife to release the transverse carpal ligament,and the observation group combined with median nerve block on the basis of the control group.The treatment effects and Genomic Scar Score(GSS)before and after treatment were compared between the two groups.Results The excellent and good rate of the observation group was 93.33%,which was higher than the control group's 60.00%(P<0.05).Before treatment,there was no statistical significance in scores of pain,numbness,waking up at night with pain,paresthesia,muscle weakening and total scores between the two groups(P>0.05).At 3 months after treatment,the scores of pain,numbness,waking up at night with pain,paresthesia,muscle weakening and total scores in both groups were lower than those before treatment;in the observation group,the pain score was(0.80±0.56)points,the numbness score was(0.67±0.72)points,the waking up at night with pain score was(0.40±0.51)points,the paresthesia score was(0.67±0.61)points,the muscle weakness score was(1.07±0.46)points and the total score was(3.61±1.96)points,which were lower than(2.07±1.03),(1.47±0.92),(1.07±0.70),(1.87±0.74),(1.80±0.68)and(8.28±2.79)points in the control group(P<0.05).Conclusion Ultrasound-guided needle knife release combined with median nerve block showed significant effect in the treatment of CTS,and has obvious advantages in improving clinical symptoms.It is worth popularizing clinically.