- 期刊
Median Nerve Recovery after Carpal Tunnel Release
腕隧道鬆弛術後之正中神經恢復
摘要
腕隧道症候群(Carpal tunnel syndrome)，是最常見單一週邊神經壓迫之神經病變，減壓手術是目前唯一可治癒的方法，而神經生理檢查(neurophysiological examination)對其診斷和術後追蹤提供了高靈敏度和專一性的方法。 回顧文獻，對於腕隧道症候群術後早期以神經生理檢查方法來追蹤神經恢復報導並不多，而且手術方法各異。本院前瞻性報告自1999年三月至2000年三月收集確定診斷為腕隧道症候群17人，以微侵犯性腕隧道減壓手術(mini-invasive carpal tunnel release)治療。於術前及術後4小時，1週，2週，4週，8週及12週分別記錄神經生理之變化情形，並與20位正常人比較發現：(1)正中神經運動支遠端潛伏期(motor distal latency)於術後四週有意義進步，於術後八週回到正常範圍。(2)正中神經感覺支遠端潛伏期(sensory distal latency)及動作電位(action potential)於術後八週有意義進步，並且回到正常範圍。(3)以微侵犯性腕隧道減壓手術(mini-invasive carpal tunnel release)治療腕隧道症候群是一有效的手術方法。
關鍵字
無資料並列摘要
Objective: Reports of nerve conduction studies following treatment for carpal tunnel syndrome are uncommon. To better understand the improvement of median nerve after release of compression over wrist in carpal tunnel syndrome patients, we studied the recovery from preoperative to postoperative period using neurophysiological methods. Design: prospective, early postoperative intervals neurophysiological investigations Materials and methods: From March 1999 to March 2000, seventeen carpal tunnel syndrome patients received minimal invasive carpal tunnel release surgery in Kaohsiung Veterans General Hospital. We compared the data of median nerve motor and sensory distal latencies, motor nerve conduction velocity, amplitudes of motor and sensory action potentials between preoperative and postoperative period. Results: We found the following: (1) The preoperative motor latency, sensory distal latency, and sensory amplitude of the median nerve of the carpal tunnel syndrome patients showed significantly abnormal in comparison with those of the normal groups. (2) The minimal invasive carpal tunnel release produced constant good result in carpal tunnel syndrome patients. (3) The median motor latency significantly improved 4wk after minimal invasive carpal tunnel release, but it took at least 8 wk for the median motor latency recovery back to normal. (4) The median sensory latency and amplitude significantly improved and back to normal since 8 wk after the operation. Conclusions: Minimal invasive carpal tunnel release is a useful method in treating carpal tunnel syndrome. The recovery of the median motor and sensory on the electrophysiological point of views is not apparent until 8 wk after operation.