内窥镜Chow法治疗腕管综合征

目的探讨内窥镜镜视下Chow法行钩刀或推刀切断腕横韧带，解除正中神经压迫的手术方法和疗效。方法2004年5月-2009年8月，对76例（85侧）腕管综合征患者采用Chow法在内窥镜镜视下行腕横韧带切开术。结果经2～18月随访，伤口均一期愈合，无血管神经损伤，无手掌部疼痛，无伤口感染，多数患者术后夜麻即消失，术后4周桡侧三个半指感觉恢复正常，麻木、疼痛症状明显缓解，10周左右拇对掌功能恢复。Kelly分级评定：优（症状完全消失）58侧，良（明显缓解）21侧，一般（症状轻度减轻）5侧，差（症状不变或加重）1侧，优良率92．94％。结论Chow法内窥镜镜视下切开腕横韧带治疗腕管综合征是安全有效的微创手术。

Treatment of carpal tunnel syndrome by Chow technique under endoscope

Objective To explore the technique and clinical effect of the treatment of carpal tunnel syndrome by Chow technique under endoscope. Methods From May 2004 to August 2009, 76 cases （85 wrists） of carpal tunnel syndrome were treated by endoscopic transverse carpal ligament release by Chow technique. The entry portal was located at the proximal wrist flexion crease level, ulnar to the palmaris longus tendon. Results Postoperative follow-up ranged from 2 to 18 months. The wounds were all primarily healed, and there was no neurovascular injury, no palm pain, no wound infection. After the operation, the ＂night-paresthesias＂ disappeared 4 weeks later, the paresthesias and pain of the radial three and half fingers of the hand disappered. The opposition dysfunction were restored to normal at 10 weeks postoperatively. According to Kelly＇s criteria, the results were excellent in 58 wrists, good in 21cases, fair in 5 cases, poor in 1 case, and the excellent and good rate was 92.94%. Conclusion The treatment of carpal tunnel syndrome by Chow technique under endoscope is a safe and efficient mini-traumatic procedure.