高频超声和电生理检查对中期腕管综合征患者疗效判定

doi:10.6040/j.issn.1671-7554.0.2015.333

Abstract

Abstract: Objective To observe the efficacy of patients with intermediate carpal tunnel syndrome(CTS)treated with oral medicine, local sealing and surgery. Methods CTS patients were divided into 3 groups according to the principle of complete voluntary: oral drug treatment group(56 cases, 85 sides), locally closed treatment group(75 cases, 108 sides), surgical treatment group(68 cases, 96 sides). After CTS patients were treated with oral medicine, local sealing or operation, the characteristics of high-frequency ultrasound and electrophysiological changes were observed. Results The effective rate of surgery was higher than that of local sealing and oral medicine. There were significant differences in the cross-sectional area of the median nerve in pisiform bone and hamate hook, and the ratio of transverse diameter and anteroposterior diameter of the hamate hook between patients with poor and good therapeutic efficacy. Even patients with poor efficacy had improved electrophysiological changes. Conclusion Surgical treatment is the most effective treatment for CTS. Larger cross-sectional area of the median nerve in pisiform bone and hamate hook, and larger ratio of the transverse diameter and anteroposterior diameter of the hamate hook mean poorer prognosis. Patients with ineffective surgical treatment still show significant electrophysiological changes after treatment.

Key words: High-frequency ultrasound, Carpal tunnel syndrome, Electrophysiological examination

CLC Number:

R745

LIANG Junli, XU Yuming. High-frequency ultrasound and electrophysiological examination to determine the efficacy of different treatments of carpal tunnel syndrome[J].JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(3): 59-62.

References

[1] Freedman M, Helber G, Pothast J, et al. Electrodiagnostic evaluation of compressive nerve injuries of the upper extremities[J]. Orthop Clin North Am, 2012, 43(4): 409-416.
[2] Chen CH, Wu T, Sun JS, et al. Unusual causes of carpal tunnel syndrome: space occupying lesions[J]. J Hand Surg Eur, 2012, 37(1):14-19.
[3] 顾雁浩, 张凯莉, 朱艺, 等. 探讨腕管综合征电生理分期的定量指标[J]. 中华手外科杂志, 2004, 20(3): 145-147. GU Yanhao, ZHANG Kaili, ZHU Yi, et al. Investigation of quantitative index for electrophysiology stage in carpal Immel syndrome[J]. Chinese Journal of Hand Surgery, 2004, 20(3):145-147.
[4] 潘生德, 顾玉东, 侍德, 等. 上肢部分功能评定试用标准[J]. 中华手外科杂志, 2000, 16(3):130. PAN Shengde, GU Yudong, SHI De, et al. Trial standard of functional assessment of upper limb[J]. Chinese Journal of Hand Surgery, 2000, 16(3):130.
[5] 吴道珠, 罗洪霞, 黄品同, 等. 超声在腕管综合征中的诊断价值[J]. 医学影像学杂志, 2008, 11(18):1299-1301. WU Daozhu, LUO Hongxia, HUANG Pintong, et al. Diagnostic value of ultrasound in carpal tunnel syndrome[J]. Journal of Medical Imaging, 2008, 11(18):1299-1301.
[6] Osterman M, Ilyas AM, Matzon JL. Carpal tunnel syndrome in pregnancy[J]. Orthop Clin North Am, 2012, 43(4):515-520.
[7] 胡继兵, 秦全菊, 程佳. 107例腕管综合征患者神经肌电图与临床分析[J]. 医学研究杂志, 2013, 42(9):131-156. HU Jibing, QIN Quanju, CHENG Jia. Analysis of the clinical features and electroneuromyography significants in 107 patients with carpal tunnel syndrome[J]. Journal of Medical Research, 2013, 42(9):131-156.
[8] 吴鹏, 杨剑云, 陈琳,等. 轻中度腕管综合征药物治疗长短期疗效[J]. 国际骨科学杂志, 2012, 4(33):270-271. WU Peng, YANG Jianyun, CHEN Lin, et al. Treatment of short and moderate carpal tunnel syndrome by drug treatment [J]. International Journal of Orthopaedics, 2012, 4(33): 270-271.
[9] 金涛. 神经电生理检测在腕管综合征临床诊断中的意义[J]. 河北医药, 2012, 2:215-216. JIN Tao. The significance of nerve electrophysiological examination in the diagnosis of carpal tunnel syndrome [J]. Hebei Medical Journal, 2012, 2:215-216.
[10] 吴佳怡, 胡静, 余斌, 等. 腕管综合征478例治疗效果评价[J]. 实用医学杂志, 2010, 24(26):4540-4542. WU Jiayi, HU Jing, YU Bin, et al. An evaluations on different therapeutic methods on 478 cases with carpal tunnel syndrome[J]. The Journal of Practical Medicine, 2010, 24(26):4540-4542.
[11] 吴鹏, 虞聪. 轻中度腕管综合征保守治疗进展[J]. 国际骨科学杂志, 2010, 31(1): 26-28. WU Peng, YU Cong. Progress of conservative treatment for mild and moderate carpal tunnel syndrome[J]. International Journal of Orthopaedics, 2010, 31(1):26-28.
[12] Ring DC. Clinical faceoff: routine electrodiagnostic testing is not helpful in the management of carpal tunnel syndrome[J]. Clin Orthop Relat Res, 2015, Feb:18.DOI 10.1007/s11999-015-4183-3.
[13] Werner RA, Andary M. Electrodiagnostic evaluation of carpal tunnel syndrome[J]. Muscle Nerve, 2011, 44(4):597-607.
[14] Cartwright MS, Hobson-Webb LD, Boon AJ, et al. Evidence-based guideline: neuromuscular ultrasound for the diagnosis of carpal tunnel syndrome[J]. Muscle Nerve, 2012, 46(2):287-293.
[15] Therimadasamy A, Pin Peng Y, Wilder-Smith EP. Carpal tunnel syndrome-median nerve enlargement restricted to the distal carpal tunnel[J]. Muscle Nerve, 2012, 46(3):455-457.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

Comments

Recommended 0

No Suggested Reading articles found!

High-frequency ultrasound and electrophysiological examination to determine the efficacy of different treatments of carpal tunnel syndrome

PDF (PC)

Abstract

Cite this article

share this article

References

Related Articles 2

Metrics

Comments

Recommended 0

[1]	WU Yiliang, ZHANG Linfeng, LI Yuan, LIU Xiaowen, XU Guangqi, GAO Feng, LÜ Renrong, HUO Ran. Ultra-high-frequency ultrasound vs high-frequency ultrasound in assessing superficial infantile hemangioma [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(12): 72-76.
[2]	BAO Hongjing, WANG Guangbin, WANG Shanshan, WU Chao. Diffusion-weighted MR neurography of the median nerve in carpal tunnel syndrome: a preliminary study [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(11): 72-75.