腕管综合征手术治疗的容积选择

A. Rushay, Y. Lisaychuk, I. Voyennyy
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摘要

腕管综合征(Carpal tunnel syndrome, CTS)常见于压迫性神经病和上肢的腕管综合征。许多手术治疗方法的存在表明,需要一个单独的方法在其实施。本文的目的是在范围方面澄清最佳干预的决定因素,并评估拟议原则的有效性。材料和方法。我们观察了52例保守治疗不成功的腕管综合征患者;腕管结构大体改变的神经肌电图和超声征象。男性19人,女性33人,分别占36.5%和63.5%。在所有患者中,干预从2.5 cm通道和腕管结构翻修开始。在大体解剖改变得到证实的情况下,通道扩大到5-5.5 cm,不仅对腕韧带进行干预,还使用显微外科技术和光学放大对改变的结构进行干预。结果。波士顿BCTQ问卷和VAS指标的动态与解剖和功能障碍的程度完全一致。这种趋势持续了4周,到第3个月和第6个月,结果接近,最后,实际上没有什么不同。结论。腕管综合征是最常见的压迫神经病和上肢隧道综合征。手术治疗方法多种多样。明确使用每种药物的适应症将使干预措施个性化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
VOLUME SELECTION OF SURGICAL TREATMENT IN PATIENTS WITH CARPAL TUNNEL SYNDROME
Carpal tunnel syndrome CTS most often occurs among compression neuropathies and tunnel syndromes of the upper limb. The existence of many surgical treatment methods indicates the need for an individual approach in their implementation. The purpose of the paper is to clarify the determining factors for the best intervention in terms of the scope and to evaluate the eff ectiveness of proposed principles. Materials and methods. We observed 52 patients with carpal tunnel syndrome with unsuccessful conservative treatment; electroneuromyographic and ultrasound signs of gross changes in the structures of the carpal tunnel. There were 19 men and 33 women (36.5% and 63.5%, respectively). In all patients, the intervention started with a 2.5 cm access and revision of the carpal tunnel structures. In cases where their gross anatomical changes were verifi ed, the access was expanded to 5-5.5 cm and the intervention was performed not only on the carpal ligament but also on altered structures using microsurgical techniques and optical magnifi cation. Results. The dynamics of indicators of the Boston BCTQ questionnaire and the VAS were in full agreement with the degree of anatomical and functional disorders. This trend persisted after 4 weeks, and by the 3rd and 6th months, the results were close and, in the end, practically did not diff er. Conclusions. Carpal tunnel syndrome is the most common of compression neuropathies and upper limb tunnel syndromes. Surgical treatments are diverse. Clarifi cations of the indications for using each of them will allow personalizing the intervention.
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