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腕關節鏡微創治療腕管綜合症的療效和安全性研究
Efficacy and safety of minimally invasive treatment of carpal tunnel syndrome with carpal arthroscopy
摘要
目的：對比分析腕關節鏡與小切口手術治療（carpal tunnel syndrome, CTS）的優缺點。方法：回顧性分析本院骨科2020年11月～2022年10月兩年中符合納入標準的單側腕管綜合症患者，按照治療方式的不同分為腕關節鏡與小切口兩組，隨訪至少13週，記錄兩組切口長度、手術時長、住院時間、術後復工時間、手術併發症、以及術後2週、6週、13週疼痛評分及兩點辨别覺數據，進行統計學分析後作出療效及安全性評定。結果：48例單側腕管綜合症患者，25例腕關節鏡組在切口長度、手術時長、住院時間、術後復工時間上均明顯優於23例小切口組，兩組均未見術後出血、血腫、神經損傷、復發、神經瘤、手或腕部肌肉異常等併發症；術後2週疼痛評分提示腕關節鏡組優於小切口組，兩組術後6週、13週疼痛評分以及術後2週、6週、13週的兩點辨别覺，均無統計學差異。結論：腕關節鏡治療腕管綜合征具有療效確切、創傷小、併發症少、恢復時間短等優點，值得推廣，但對術者手術技巧有較高要求，且仍具一定治療局限性。
並列摘要
Objective: To compare and analyse the advantages and disadvantages of carpal arthroscopy and small incision surgery in the treatment of carpal tunnel syndrome (CTS). Methods: 48 patients with unilateral carpal tunnel syndrome (CTS) who fulfilled the inclusion criteria in the Department of Orthopedics of Kiang Wu Hospital in the two-year period from November 2020 to October 2022 were analyzed in a retrospective study, and were divided into a carpal arthroscopy group and a small incision group according to the treatment modality, and were followed up for at least 13 weeks after surgery. The incision length, duration of surgery, hospital stay, postoperative recovery time, surgical complications, pain scores at 2 weeks, 6 weeks, and 13 weeks after surgery, and two-point discrimination sensation data were recorded for statistical analysis to assess the efficacy and safety of the treatment. Results: The carpal arthroscopy group was significantly better than the small incision group in terms of incision length, duration of surgery, hospital stay, and postoperative recovery time, and there was no postoperative bleeding, hematoma, neurological injury, recurrence, and other problems in either group. There were no postoperative complications such as bleeding, hematoma, nerve injury, recurrence, neuroma, muscle abnormality of the hand or wrist, etc. The pain scores at 2 weeks after surgery suggested that the carpal arthroscopy group was better than the small incision group, and there was no significant difference in the pain scores of the two groups at 6 weeks and 13 weeks after surgery, and the two-point discrimination sensation at 2 weeks, 6 weeks, and 13 weeks after surgery. Conclusion: Carpal arthroscopy treatment of carpal tunnel syndrome has the advantages of effective treatment, being less invasive, resulting in fewer complications and a shorter recovery time, which is worthy of promotion. However, it requires a higher level of surgical skills and still has some therapeutic limitations.