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显微镜辅助神经束膜松解对中重度肘管综合征的治疗评价
作者:陈佳1 2  张吉涛1  李政1  郝定均3  单乐群1 3 
单位:1. 第四军医大学唐都医院 骨科, 陕西 西安 710038;
2. 解放军第153中心医院 手外科, 河南 郑州 450042;
3. 西安市红会医院 骨科, 陕西 西安 710054
关键词:肘管综合征 神经束膜松解 显微镜 
分类号:R681.7
出版年·卷·期(页码):2017·36·第十一期(1548-1551)
摘要:

目的:观察显微镜辅助神经束膜松解治疗中重度肘管综合征的临床疗效。方法:回顾性分析唐都医院骨科2010年6月至2015年6月行显微镜辅助下神经束膜松解和单纯尺神经前置术治疗的77例中重度肘管综合征患者的临床资料,比较两种术式对中度及重度肘管综合征患者术后优良率的差异。结果:中度肘管综合征或不明病因的重度肘管综合征患者两种术式的术后优良率分别为100%、91.67%,差异无统计学意义(P=0.706);伴随肘外翻畸形或骨性关节炎的重度肘管综合征患者行显微镜辅助神经束膜松解术后优良率为96.13%,明显高于行尺神经前置术的76.47%(P=0.006)。结论:对伴随肘外翻畸形及骨性关节炎的重度肘管综合征采用显微镜辅助神经束膜松解可以改善治疗效果。

Objective:To observe the clinical effects of microscope assisted interfascicular neurolysis in the treatment of moderate to severe cubital tunnel syndrome (CTS). Methods:From June 2010 to June 2015, patients with moderate to severe CTS in our department were treated with microscope assisted interfascicular neurolysis or anterior subcutaneous transposition of ulnar nerve only. In this retrospective study, the effectiveness of the two treatments was evaluated and the percentage of the cases received good or excellent recovery were calculated. The excellent and good rate was compared in moderate and severe CTS patients between these two kind of different operations respectively. Results:No significant difference in postoperative excellent and good rate was found in moderate CTS patients and severe idiopathic CTS patients between interfascicular neurolysis group or anterior subcutaneous transposition of ulnar nerve group. In severe CTS patients with elbow valgus deformity or osteoarthritis who underwent interfascicular neurolysis had a better postoperative excellent or good rate(P<0.05). Conclusion:The severe cubital tunnel syndrome with elbow valgus deformity or osteoarthritis patients treated with microsurgical interfascicular neurolysis operation can achieve better clinical effect.

参考文献:

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[2] 虞聪,顾玉东.对中重度肘管综合征治疗方式的探讨[J].中华手外科杂志,2000,16(3):156-158.
[3] 潘达德,顾玉东,侍德,等.中华医学会手外科学会上肢部分功能评定试用标准[J].中华手外科杂志,2000,16(3):130-135.
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