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題名 | Endoscopic Carpal Tunnel Release=內視鏡腕道症候群手術 |
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作者 | 陳煥棠; 陳宏基; 魏福全; Chen, Huan-tang; Chen, Hung-chi; Wei, Fu-chan; |
期刊 | 長庚醫學 |
出版日期 | 19990900 |
卷期 | 22:3 1999.09[民88.09] |
頁次 | 頁386-391 |
分類號 | 416.615 |
語文 | eng |
關鍵詞 | 腕道症候群; 內視鏡腕道症候群手術; Carpal tunnel syndrome; Endoscopic carpal tunnel release; |
中文摘要 | 背景:1989年Dr. Okutsu與Chow發展內視鏡腕道症候群手術,許多報告指出內 視鏡腕道症候群手術可減少手掌傷口疼痛,而患者又能很快回到工作崗位,本文報告1214 內視鏡腕道症候群的手術。 方法:1278腕道症候群手術完成於948患者,1214內視鏡腕道症候群手術完成於884 患者,所使用之方法為改良式Menon手術方法,其餘64腕道症候群則應用傳統開刀方法。 結果:內視鏡腕道症候群手術立即的併發症包括了24例無法由內視鏡完成而改為傳統 開刀方法,其中還包括了1例正中神經受傷。在自發性與使用過度引起的腕道症候群,600 例內視鏡腕道症候群手術與59例傳統開刀手術之患者追蹤至少3個月,在內視鏡組81%在 手掌中間有疼痛感覺,31%有不一樣的麻木感,40%發生手掌中柱狀疼痛,80.9%在4個星 期中手握力恢復到手術前的握力;在傳統開刀手術法,在4星期中恢復握力約59.3%,內視 鏡與傳統方法比較是有意義的(p=0.00011)。 結論:我們的經驗與結果,指出內視鏡腕道症候群手術,確實可減少術後手掌疼痛,提 早恢復工作,手術併發症不多,只要手術中多加注意,可避免併發症的發生。 |
英文摘要 | Background: Endoscopic carpal tunnel release was developed by Okutsu and Chow in 1989. Many reports have indicated that endoscopic carpal tunnel release diminishes postoperative pain and accelerates the recovery time. Methods: In a series of 1278 carpal tunnel release procedures (in 948 patients), 1214 were performed with a modified Menon endoscopic method and the remaining 64 with an open procedure. The patients with idiopathic carpal tunnel syndrome were followed for at least 3 months. Results: Of the endoscopic release patients, 80.9% recovered grip strength equal to or greater than preoperative levels within 4 weeks, whereas in the open procedure group, the rate was only 59.3%. The difference was statistically significant (p=0.00011). An immediate complication was one median motor nerve severance. There were 24 conversions to a conventional open procedure during endoscopic release. In the endoscopic group, 81% developed scar tenderness over the thenar crease, 31% developed new sensory disturbance, and 4% developed pillar pain. Conclusion: Endoscopic release facilitated the recovery of grip strength and diminished the frequency of scar tenderness. However, neurovascular injury should be carefully prevented. |
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