【摘要】 【目的】设计及应用小切口作腕管切开术 ,并分析其治疗腕管综合征的疗效。【方法】在远侧腕横纹远侧 1cm ,大鱼肌纹尺侧 0 .5cm作 2 .5～ 3cm切口 ,直视下切开腕横韧带 ,切除增生水肿的屈肌腱滑膜 ,在放大 6倍头戴式放大镜下显微松解正中神经。【结果】术后随访 3个月至 2年 ,2 5例症状完全消失 ,2例大部分症状缓解。拇、示、中指指腹两点辨别觉恢复正常 ,术后 9例大鱼肌萎缩者 ,肌萎明显改善 ,拇指对掌功能恢复正常。无一例产生腕掌部瘢痕痛及尺神经、掌浅弓损伤等并发症。【结论】小切口直视下微创显微神经松解术是治疗腕管综合征的一种疗效确切的新方法。更多还原

【Abstract】 Objective To design and apply small incision technique for carpal tunnel release and analyze its therapeutic efficacy in the treatment of carpal tunnel syndrome (CTS).Twenty-seven cases of CTS were operated . A small incision of 2.5～3.0 cm in length was made at the level of 1.0 cm distance from the distal transverse wrist crease and 0.5cm nearby the ulnar side of thenar .muscle crease. The transverse wrist ligament was cut under direct vision, and synovium of proliferated and edematous flexor tendon was resected. The median nerve was released finally under loupe with 6-fold magnification.The patients were followed up for 3～24 months postoperatively, the symptoms of numbness and pain disappeared completely in 25 cases and partly in 2 cases. Sense of two point distance (2-PD) differentiation in the pulp of thumb, index finger and long finger returned to normal (< 4 mm). Thenar muscle atrophy in 9 patients was greatly improved with recovery of normal function of thumb opponens. Pillar scar pain, injury of the ulnar nerve and superficial palmar arch were not found.[Conclusion]Mini-incision microsurgical endoneurolysis under direct vision is a reliable and effective new approach for treatment of CTS.更多还原