有限小切口松解与常规切开松解修复腕管综合征的Meta分析

背景：自1991年以来,许多医师在使用腕横纹开放式小切口技术试图结合传统腕管切开松解的简单性和安全性减少组织损伤和术后复发率。但哪一种技术更具优势一直存在争议。目的：对非内窥镜的有限小切口松解和传统腕管切开松解治疗腕管综合征的疗效进行系统评价。方法：按照Cochrane系统评价的方法,计算机检索MEDLINE（1966年1月至2010年3月）、EMBASE（1966年1月至2014年5月）、Cochrane图书馆（2014年5月）及中国生物医学文献数据库（1979年1月至2013年12月）,并手工检索相关的中英文骨科杂志。收集所有相关的随机对照试验,并评价纳入研究的方法学质量,采用Cochrane协作网提供的软件Revman5.2进行Meta分析,以获得有限小切口松解与传统腕管切开松解治疗腕管综合征的疗效及其安全性是否有差异的相关证据。结果与结论：共纳入7个随机对照试验进行评价。Meta分析显示,有限小切口松解组与传统腕管切开松解组的瘢痕痛、柱状痛,主观满意率、治疗后恢复日常工作时间差异无显著性意义（P〉0.05）;有限小切口松解组后并发症发生率和手术时间显著低于传统腕管切开松解组（P〈0.05）。结果表明,与传统腕管切开松解相比,有限小切口松解可降低腕管综合征治疗后并发症,缩短手术时间;两种术式治疗后瘢痕痛率、柱状痛率、主观满意度、恢复日常工作时间差异无显著性。因研究质量及样本的局限性,此两种治疗方法与治疗后恢复时间、治疗后疼痛和手功能等指标的比较上有待进一步研究。

Meta-analysis of limited mini incision release and traditional open carpal tunnel release for treatment of carpal tunnel syndrome

BACKGROUND： Since 1991, many physicians try to combine the small open-incision along the wrist crease with traditional carpal tunnel release that is simple and safe to reduce tissue damage and recurrence rate. But what kind of techniques is superior has been controversial. OBJECTIVE： To compare the efficacy and safety of limited mini incision （non-endoscopic） carpal tunnel release with traditional open carpal tunnel release for carpal tunnel syndrome. METHODS： Based on Cochrane Systematic Review, we searched through the MEDLINE （1966-01/2010-03）, EMBASE （1966-01/2014-05）, Cochrane Library （2014-05） and CBM disc （1979-01/2013-12）, and relevant seven Chinese and English orthopedic journals by hand. Then, we collected all the randomized control trials related to carpal tunnel syndrome. The quality of trials was critically assessed. The Revman5.2.2 that provided by Cochrane Collaboration was used for data management and analysis on the evidence of the difference in the efficacy and safety of limited mini incision carpal tunnel release versus traditional open carpal tunnel release. RESULTS AND CONCLUSION： Totally seven randomized controlled trials were included by total retdeve and screening The results of meta-analysis showed no significant differences in the scar tenderness, pillar pain, subjective satisfaction and recovery time between groups of limited mini incision carpal tunnel release and traditional open carpal tunnel release （P 〉 0.05）. The rate of complications and operation time in group of limited mini incision carpal tunnel release were lower than those in group of traditional open carpal tunnel release （P 〈 0.05）. Compared with the traditional open carpal tunnel release, the limited mini incision carpal tunnel release can reduce the rate of postoperative complications rate and operation time. There is no significant statistical difference in the rate of scar tenderness, pillar pain, subjective satisfaction and recovery time between the two approaches. However, owin