内窥镜下治疗腕管综合征89例报告

目的 :探讨应用内窥镜技术治疗腕管综合征 (ECTR) ,从腕管内切断腕管横韧带 ,解除其对正中神经压迫的手术方法及技巧。并对其术后疗效进行分析 ,介绍内窥镜下治疗腕管综合征的经验与疗效。方法 :局部麻醉 ,皮肤 1cm切口 ,在内窥镜下切断腕管横韧带。松解受压的正中神经。据Kelly疗效评定标准 ,对其术后疗效进行分析评价。结果 :临床应用 165例 192腕 ,手术时间平均 10min ,出血少 ,术后随访 89例 98腕 ,优 73腕 ;良 2 0腕 ;一般 3例 ;差 2例 ,其中 2例发生术后正中神经粘连 ,行 2次手术。结论 :内窥镜技术治疗腕管综合征 (ECTR)皮肤切口小 ,组织创伤轻 ,手术时间短 ,术后不需石膏外固定 ,不残留手术瘢痕。注意手术适应证 ,是一种安全有效的微创手术方法。

Experiments report on endoscopic management of carpal tunnel syndrome of 89 cases

Objective: To investigate the experiments and clinical work on endoscopic management of carpal tunnel syndrome.Methods:A 1cm skin incision is made under local anaesthesia.The transverse carpal ligament were cut under endoscope and the median nerve was released.According to Kelly's evaluation principle,functional assessment were made in every type after operation.Follow-up was conducted in the sixth month after the operation.Results:One hundred and ninty-two sides of 165 cases of carpal tunnel syndrome (CTS) were treated with the methods.And 98 sides of 89 cases of CTS were followed up.Results:Seventy-three cases were excellent;20 cases were good;3 cases were fair;2 cases were poor.The average time of the operation were ten minutes.There was less blood losing in the procedure.Two cases' surgical complication were encountered and were reoperated.Conclusions:Endoscopic carpal tunnel release(ECTR)has the advantages of smaller incision,less tissue damage,shorter operation time,less skin scar and no post-operation plastic splint.This study suggests that ECTR for CTS is a safe and reliable procedure with a high success rate when the surgeons pay attention to the indication of procedure.