腕管综合征的发病过程与腕关节过度屈伸和劳损有关,为探究用超声辅助内镜技术治疗腕管综合征的疗效及安全性,选择2019年6月至2020年12月南通大学第二附属医院收治的51例单侧腕管综合征患者,在超声辅助行内镜下腕横韧带松解术,分别于术前、术后1个月、术后3个月进行波士顿腕管量表的症状严重程度评分(SSS)及功能状态评分(FSS)、测量钩骨水平正中神经扁平率(FR),最终评估其疗效及安全性。术后51例患者均获得随访,患者术后1个月、术后3个月SSS评分及FSS评分较术前均明显下降,有统计学意义(P<0.05); FR在术后1个月、术后3个月逐渐下降,有统计学意义(P<0.05);根据腕管综合征与肘管综合征功能评定标准的现状与建议,优良率94.1%,术后均未有血管神经损伤、感染等并发症发生。借助超声辅助内镜技术治疗腕管综合征的术野清晰、安全性高、创伤小,患者症状缓解迅速、术后恢复快,值得临床推广。
The pathogenesis of the carpal tunnel syndrome is related to the excessive flexion and extension of the wrist joint and the strain, such as due to the improper posture of grasping the snowstick when skiing. This paper evaluates the effect and the safety of ultrasound-assisted endoscopic carpal tunnel release. 51 patients with unilateral carpal tunnel syndrome admitted to our hospital from June 2019 to December 2020 are selected to be treated with the endoscopic transverse carpal ligament release assisted by ultrasound. In addition, the Boston Carpal Tunnel Scale Symptom Severity Scale (SSS), the Boston Carpal Tunnel Scale Functional Status Scale (FSS), the median nerve flattening rate at the level of the hamate bone (FR) are recorded before the surgery, and 1 month and 3 months after the surgery. According to the follow-up among the 51 patients, the SSS score and the FSS score of patients 1 month and 3 months after the surgery are significantly lower than those before the surgery, with statistical significance (P<0.05) and the FR is decreased gradually 1 month and 3 months after the surgery, with statistical significance (P<0.05). According to the current status and the suggestions in the functional evaluation standard for the carpal tunnel syndrome and the cubital tunnel syndrome, the good rate is 98.0%, because of no vascular nerve injury, infection and other complications. Endoscopic transverse carpal ligament release assisted by ultrasound can visualize the transverse carpal ligament and its surrounding anatomical structure through a small incision to evaluate the release effect of the transverse carpal ligament and to reduce the complications of the vascular and nerve injury. Besides, the postoperative patients have recovered well and are satisfied with the treatment effect, so the treatment is worthy of clinical promotion.
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