超声介导药物联合针刀治疗腕管综合征

目的探讨超声介导药物联合针刀治疗腕管综合征(CTS)的临床应用价值。方法对62侧来自56例CTS患者的手腕行超声检查,观察正中神经的改变及毗邻关系,选择最佳穿刺点,实时超声介导下行药物注射及针刀治疗。术后1、4、12周进行随访,应用视觉模拟评分法(VAS)评定术前、术后患者疼痛程度。结果超声显示58侧患腕正中神经有异常改变,4侧正中神经未见异常;1侧术前评估不宜接受超声介导药物联合针刀治疗,另61侧超声介导药物联合针刀治疗均操作成功,未发生神经损伤及其他并发症。术前及术后1、4、12周的VAS评分分别为8.25±0.81、4.27±0.72、3.00±0.54及1.44±0.54,差异均有统计学意义(P0.05)。结论超声介导药物联合针刀治疗CTS具有可视化、安全有效、无辐射等优点,值得临床推广。

Ultrasound-guided drug and acupotomy treatment for carpal tunnel syndrome

Objective To explore the clinical application value of ultrasound-guided drug and acupotomy treatment for carpal tunnel syndrome (CTS). Methods The 62 wrists from 56 patients with CTS underwent ultrasound, in order to choose the optimal puncture point, the changes and adjacent relationship in the median nerve were observed. Drug injection and acupotomy were performed under real-time ultrasound guidance. All the patients were followed up for 1, 4, 12 weeks and visual analogue scal (VAS) were assessed before and after operation. Results Ultrasound showed the changes of median nerve in 58 wrists with CTS, while 4 sides of the median nerve was normal. One wrist was not appropriate for ultrasound-guided drug and acupotomy by preoperative evaluation. Ultrasound-guided drug and acupotomy treatment was applied to 61 wrists. Ultrasound-guided puncture was all successful, and no nerve injury nor other complications occurred. The VAS score of preoperative and 1, 4 and 12 weeks after treatment was 8.25±0.81, 4.27±0.72, 3.00±0.54 and 1.44±0.54, respectively (all P<0.05). Conclusion Ultrasound-guided drug and acupotomy treatment for CTS has the advantages of visualization, safety, validity, no radiation, and is expected to be popularized.