内镜下手术治疗腕管综合征的应用分析

目的探讨内镜下手术治疗伴有滑膜增生腕管综合征(CTS)的临床疗效。方法回顾性分析在该院手术治疗的37例(41腕)伴有腱周滑膜组织增生的CTS患者,术中均在内镜下切断腕横韧带,同时经内镜入口切除指浅屈肌腱周围增生的滑膜。比较患者手术前后临床症状、体征改变,统计术后优良率。结果按Kelly分级,术后整体优良率为95.12%。夜间麻醒症状均消失,Tinel征、Phalen征阳性率降低至2.44%(P0.05),两点辨别觉平均值低至(3.5±0.9)mm(P0.05),无严重并发症。结论对于伴有腕管内滑膜轻度增生的特发性CTS患者,内镜下腕横韧带切开联合滑膜组织切除,是一种新的、可行的、近期疗效显著的治疗方式,值得临床推广。

Application and analysis of endoscopic surgery in treating carpal tunnel syndrome

Abstract: Objective To investigate the clinical effect of endoscopic treatment of carpal tunnel syndrome (CTS) with subsynovial hyperplasia. Methods 37 cases (total 41 wrists) of CTS with subsynovial hyperplasia who accepted endoscopic treatment in our hospital were retrospectively analysised, all the transverse ligament of wrist were cutted off under endoscope and the hyperplastic subsynovial membrane arounding the superficial flexor tendon of finger. The changes of clinical symptoms and signs before and after operation were compared. Results According to Kelly classification, the overall excellent and good rate was 95.12%. After operation, the feel of numb and pain during night disappeared in all patients, the positive rate of Tinel and Phalen sign was both reduced to 2.44% (P < 0.05), and the mean value of two-point discrimination was reduced to (3.5 ± 0.9) mm. No serious complication occurred during treatment. Conclusion For the patients of CTS with subsynovial hyperplasia, to cut the transverse ligament tendon under endoscope and remove the subsynovial around the flexor tendon at the same time is a new and feasible surgical procedure with notable curative effect, which deserves clinical popularization.