腕管综合征(诊断和治疗)

Devi Annisa, S. Rianawati, Masruroh Rahayu, N. Raisa, S. Kurniawan
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摘要

腕管综合征(Carpal Tunnel Syndrome, CTS)是一种影响正中神经的神经病变,发病率约为90%。腕管综合征出现在3.8%的普通人群中,女性患病率最高。有几个与CTS相关的危险因素,即医疗和非医疗因素。到目前为止,腕管综合征的发病机制仍然非常复杂,尚不确定,但正中神经的压迫和牵引因素被认为是导致腕管综合征的最常见原因。腕管综合征在临床上可表现为感觉异常、本体感觉改变、轻瘫等主观体征,也可表现为运动敏感性和功能改变、Tinel和Phallen试验阳性、鱼际肌萎缩等客观体征。腕管综合征的诊断是基于手部正中神经分布的疼痛、麻木、刺痛和/或烧灼感的经典症状,以及基于神经传导研究的正中神经功能异常。保守治疗是一种选择。尤其适用于有轻至中度症状的腕管综合征患者。保守治疗可采用皮质类固醇和物理治疗的形式。严重CTS或保守治疗4 ~ 6个月后症状仍未改善的患者应考虑手术治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CARPAL TUNNEL SYNDROME (DIAGNOSIS AND MANAGEMENT)
Carpal Tunnel Syndrome (CTS) is a neuropathy disease that affects the median nerve with an incidence of around 90%. Carpal Tunnel Syndrome appears in 3.8% of the general population, with the highest prevalence occurring in women. There are several risk factors associated with CTS, namely medical and non-medical factors. The mechanism of carpal tunnel syndrome until now is still very complex and is not known with certainty, but compression and traction factors in the median nerve are thought to be the most common cause of CTS. Carpal Tunnel Syndrome can manifest clinically with subjective signs such as paresthesia, proprioceptive changes, and paresis, as well as objective signs, such as changes in motor sensitivity and function, positive Tinel and Phallen tests, and thenar muscle atrophy. The diagnosis of Carpal Tunnel Syndrome is based on the classic symptoms of pain, numbness, tingling, and/or burning sensation in the distribution of the median nerve in the hand, as well as the abnormal function of the median nerve based on nerve conduction studies. Conservative therapy is an option. Especially in Carpal Tunnel Syndrome patients with mild to moderate symptoms. Conservative therapy can be given in the form of corticosteroid and physical therapy. Patients with severe CTS or whose symptoms have not improved after four to six months of conservative therapy should be considered for surgical treatment.
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