| 摘要: |
| 目的:分析小切口松解正中神经术联合穴位注射序贯疗法治疗腕管综合征(CTS)的临床疗效，以及对患者神经功能的影响。方法:选取2018 年6 月—2020 年6 月在我院治疗的CTS 患者60 例，随机分为对照组和观察组，每组30 例。两组患者均由同一组医师实施小切口松解正中神经术治疗，根据术后所采用的康复治疗措施不同将其分为观察组和对照组。两组患者术后均采用神经营养药物弥可保治疗，对照组采用口服治疗，观察组患者采用穴位注射治疗。10 d 为1 个疗程，两组患者均连续治疗2 个疗程。对两组患者术前、术后1、2、3、4、5、6、9、12 月各随访1 次。比较两组患者术前1 d、术后6 个月、术后12 月的Levine 腕管综合征程度评分及肌电图指标:正中神经的感觉传导速度(SCV)、感觉神经动作电位波幅(SNAP)、运动神经末端运动潜伏期(DML)，术后康复治疗2 个疗程后，比较两组疗效及治疗期间不良反应发生率。结果:术后6、12 个月，两组患者严重程度评分、功能状态评分及Levine 总评分均较术前1 d 下降，且术后6、12 个月观察组患者的上述评分均低于对照组，差异有统计学意义(P ＜ 0.05)。术后6、12 个月，两组患者正中神经SCV、SNAP 均较术前1 d 上升，且观察组高于对照组，DML 均较术前下降，且观察组低于对照组，差异有统计学意义(P ＜ 0.05)。术后康复治疗2 个疗程后，观察组临床总有效率高于对照组(P ＜ 0.05)。两组患者治疗期间药物不良反应率比较差异无统计学意义(P ＞ 0.05)。结论:小切口松解正中神经术联合穴位注射序贯疗法治疗腕管综合征可有效提升患者的临床疗效，促进神经功能恢复，且安全性高，具有较高的临床价值。 |
| 关键词: 腕管综合征 小切口松解正中神经术 穴位注射 弥可保 神经功能 不良反应 |
| DOI：10.3969/j.issn.1007-6948.2021.06.008 |
| 投稿时间：2020-12-29 |
| 基金项目: |
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| Analysis of Therapeutic Effects of Median Neurolysis with Small Incision Combine with Acupoint Injection and Sequential Therapy in Treatment of Carpal Tunnel Syndrome |
| ZHOU Jia-xin,LING Li,WANG Lin |
| Department of Hand and Foot Surgery, Keqiao District Hospital of Traditional Chinese Medicine, Shaoxing312030, China |
| Abstract: |
| Objective To analyze the clinical efficacy of median neurolysis with small incision combine with acupoint injection and sequential therapy in the treatment of carpal tunnel syndrome (CTS) and its effect on nerve function. Methods 60 patients with CTS treated in our hospital from June 2018 to June 2020 were randomly divided into control group and observation group, with 30 cases in each group. The two groups of patients were treated with median neurolysis with small incision by the same group of doctors. They were divided into observation group and control group according to the postoperative rehabilitation measures. Both groups were treated with neurotrophic drug mecobalamin. The control group was treated with oral treatment and the observation group was treated with acupoint injection. 10 days was a course of treatment and both groups were treated for 2 consecutive courses. The patients in the two groups were followed up once before operation and 1, 2, 3, 4, 5, 6, 9 and 12 months after operation. The Levine carpal tunnel syndrome score and EMG indexes: median nerve sensory conduction velocity (SCV), sensory nerve action potential amplitude (SNAP), motor nerve terminal motor latency (DML) were compared between the two groups before operation, 6 months and 12 months after operation. After two courses of postoperative rehabilitation treatment, the curative effects and the incidence of adverse reactions were compared between the two groups. Results 6 months and 12 months after operation, the severity score, functional state score and Levine total score of the two groups were lower than those of the control group, and the above scores of the observation group were lower than those of the control group (P＜ 0.05). 6 months and 12 months after operation, the SCV and SNAP of median nerve in the two groups increased compared with 1 day before operation, the DML in the observation group was higher than that in the control group and the DML in the observation group was lower than that in the control group (P＜ 0.05). After two courses of postoperative rehabilitation treatment, the total clinical effective rate in the observation group was higher than that in the control group (P＜0.05). There was no significant difference in the rate of adverse drug reactions between the two groups (P＜0.05). Conclusion Median neurolysis with small incision combine with acupoint injection and sequential therapy in the treatment of carpal tunnel syndrome can effectively improve the clinical ef.cacy and promote the recovery of nerve function, with high safety and high clinical value. |
| Key words: Carpal tunnel syndrome median neurolysis with small incision acupoint injection mecobalamin neurological function adverse reaction |
