腕管镜及改良小切口松解法治疗糖尿病腕管综合征的疗效分析

摘要

目的 探讨腕管镜腕管松解术和改良小切口腕管松解术治疗糖尿病腕管综合征的临床疗效和安全性差异.方法 回顾性分析腕管综合征合并糖尿病患者86例,其中43例患者行双孔道腕管镜腕管松解术(A组),43例患者行改良小切口腕管松解术(B组),随访10 ～ 24个月,统计两组患者的手术时间、住院时间、恢复工作时间、术后并发症和临床疗效.结果 A组和B组患者的优良率分别为93.02％和90.70％,两组的优良率比较差异无统计学意义(P＞0.05);A组患者的住院时间[(5.5±2.7)vs(6.8±2.9)d]及术后恢复工作时间[(19.3±3.1)vs(21.5±3.3)d]少于B组,差异有统计学意义(P＜0.05),而两组患者的手术时间、术后并发症发生率比较均差异无统计学意义(P＞0.05).结论 腕管镜腕管松解法和改良小切口腕管松解法均是治疗糖尿病腕管综合征的有效且安全的手术方法,腕管镜腕管减压术患者住院时间短、术后恢复快,对于机体修补能力较差的糖尿病患者更为适合.%Objective To investigate the different clinical efficacy and safety of the treatment of diabetic carpal tunnel syndrome with the carpal tunnel mirror and modified small incision oral carpal tunnel release surgery.Methods Retrospective analysis was made of 86 cases with carpal tunnel syndrome complicated with diabetes that were treated and had follow-up data.There were 43 cases treated by double channel carpal tunnel mirror carpal tunnel release surgery (A group) while 43 patients treated by modified small incision oral carpal tunnel release surgery (B group).The patients were followed up for 10 to 24 months and the operation time,hospitalization time,recovery time,postoperative complications and clinical efficacy were counted.Results The excellent and good rates of A group and B group were 93.02％ and 90.70％,respectively.There was no significant difference in the excellent and good rate between the two groups (P ＞ 0.05);the hospitalization time and postoperative recovery time of A group [(5.5 ± 2.7) vs (6.8 ± 2.9) d] was significantly less than B group [(19.3 ± 3.1) vs (21.5 ± 3.3) d];the difference was statistically significant (P ＜ 0.05).The operation time,postoperative complication rate of two groups were not statistically significant (P ＞ 0.05).Conclusions Both the carpal tunnel mirror carpal tunnel lysis and the improved small incision for carpal tunnel loosening therapy in the treatment of diabetic carpal tunnel syndrome is a safe and efficient operation,yet the carpal tunnel mirror carpal tunnel lysis with shorter hospital stay and faster postoperative recovery is more suitable for the patients with poor repair ability of diabetes.