【摘要】：目的通過meta分析，對(duì)內(nèi)鏡下腕管松解術(shù)(endoscopic carpal tunnel release，ECTR)和常規(guī)腕管開放手術(shù)（open carpal tunnel release，OCTR）治療腕管綜合征（carpal tunnel syndrome，CTS）的術(shù)后療效進(jìn)行比較，比較兩種術(shù)式的優(yōu)劣。 方法對(duì)MEDLINE、Cochrane圖書館、CNKI數(shù)據(jù)庫、萬方數(shù)據(jù)庫及相關(guān)會(huì)議進(jìn)行檢索，收集1989年~2014年的所有相關(guān)的隨機(jī)對(duì)照試驗(yàn)，按制定納入標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn)篩選文獻(xiàn)，利用Revman5.0軟件對(duì)相關(guān)數(shù)據(jù)進(jìn)行meta分析。 結(jié)果總共納入22篇相關(guān)文獻(xiàn)，包括手術(shù)1962例，其中內(nèi)鏡治療組930例，開放手術(shù)治療組1032例。Meta分析結(jié)果表明，ECTR組與OCTR組在手術(shù)時(shí)間（MD=1.96；95%CI [-0.25，4.18]，，P=0.08）、術(shù)后緩解率（MD=0.87；95%CI [0.55，1.39]，P=0.57）、術(shù)后并發(fā)癥發(fā)生率(MD=0.67；95%CI [0.42，1.05]，P=0.08)以及術(shù)后患者滿意度(MD=1.58；95%CI [0.96，2.60]，P=0.07)方面，均無明顯統(tǒng)計(jì)學(xué)差異（P＞0.05）；ECTR組在術(shù)后捏力（MD=0.77；95%CI [0.13，1.41]，P=0.02）與握力（MD=5.25；95%CI [0.03，10.48]，P=0.05）方面，均優(yōu)于OCTR組（P＜0.05）。 結(jié)論ECTR組在術(shù)后捏力與握力方面優(yōu)于OCTR組，而在手術(shù)時(shí)間、術(shù)后緩解率、術(shù)后并發(fā)癥發(fā)病率以及術(shù)后患者滿意度上，兩種術(shù)式并無明顯差異。
[Abstract]:Objective to compare the postoperative efficacy of endoscopic carpal tunnel release (endoscopic carpal tunnel release) and conventional open carpal tunnel operation (open carpal tunnel release) in the treatment of carpal tunnel syndrome (carpal tunnel syndromes) by meta analysis, and compare the advantages and disadvantages of the two methods. Methods the CNKI database, Wanfang database and related conferences were searched by MEDLINE Cochrane Library. All the relevant randomized controlled trials from 1989 to 2014 were collected, and the literature was screened according to the inclusion criteria and exclusion criteria. Revman5.0 software is used to analyze the related data by meta. Results A total of 22 related literatures were included, including 1962 cases of operation, including 930 cases in endoscopic therapy group and 1032 cases in open operation group. The results showed that the operative time (MD1.96 ~ 95CI [-0.254.18]) and the postoperative remission rate (MD0.87) were found in the two groups (MD1.96 ~ 95CI [-0.254.18]). There were no significant differences in postoperative pinch strength (MD0.7795CI [0.131.41]) and postoperative grip strength (MD5.2595CI [0.0310.48] P0. 05) in 95%CI group (P > 0. 05), the incidence of postoperative complications (MDT 0.67% 95 CI [0. 42 鹵1. 05] P0. 08) and postoperative patient satisfaction (MD1. 5895 CI [0. 96 鹵2. 60] P0. 07) were better than those in OCTR group (P < 0. 05). Conclusion the postoperative pinch strength and grip strength in ECTR group were better than those in OCTR group, but there was no significant difference in operation time, postoperative remission rate, incidence of postoperative complications and postoperative patient satisfaction.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R688

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