【摘要】：目前缺乏腕管綜合征術(shù)后正中神經(jīng)形態(tài)變化的定量研究,以及形態(tài)變化指標(biāo)對(duì)術(shù)后評(píng)估的作用。本研究通過(guò)觀(guān)察腕管綜合征正中神經(jīng)術(shù)前術(shù)后形態(tài)學(xué)改變情況,并探討正中神經(jīng)形態(tài)學(xué)變化指標(biāo)與早期療效的相關(guān)性。應(yīng)用高頻超聲和磁共振測(cè)量46例腕管綜合征正中神經(jīng)術(shù)前及術(shù)后腕管入口(豌豆骨平面)、腕管出口(鉤骨鉤平面)的橫截面積及橫截面的橫徑和前后徑,計(jì)算出術(shù)前術(shù)后正中神經(jīng)在腕管入出口的腫脹率和扁平率,以及術(shù)前術(shù)后橫截面積、腫脹率和扁平率的變化值。術(shù)后3個(gè)月對(duì)其早期療效進(jìn)行評(píng)分,并將術(shù)前術(shù)后正中神經(jīng)的形態(tài)學(xué)變化指標(biāo)與術(shù)后早期療效進(jìn)行相關(guān)性分析。高頻超聲檢查正中神經(jīng)術(shù)后入口區(qū)橫截面積較術(shù)前減小(0.196±0.155)%,腫脹率減小(0.211±0.131)%;腕管出口區(qū)正中神經(jīng)橫截面積較術(shù)前減小(0.086±0.241)%,腫脹率減小(0.733±0.096)%,扁平率減小(0.122±0.082)%。磁共振檢查正中神經(jīng)術(shù)前術(shù)后入口區(qū)橫截面積較術(shù)前減小(0.142±0.190)%,腫脹率減小(0.233±0.285)%;腕管出口區(qū)正中神經(jīng)橫截面積較術(shù)前減小(0.087±0.256)%,腫脹率減小(0.052±0.271)%,扁平率減小(0.760±0.544)%。兩種檢查數(shù)據(jù)均顯示出腕管松解術(shù)后正中神經(jīng)形態(tài)有顯著變化,腕管入口區(qū)橫截面積及腫脹率變化與術(shù)后早期療效有顯著相關(guān)性,可作為術(shù)后早期療效的預(yù)測(cè)指標(biāo)。
[Abstract]:At present, there is a lack of quantitative study on the morphologic changes of median nerve after carpal tunnel syndrome and the effect of morphological changes on postoperative evaluation. In this study, the morphological changes of median nerve in carpal tunnel syndrome were observed before and after operation, and the correlation between morphological changes of median nerve and early curative effect was discussed. High frequency ultrasound and magnetic resonance were used to measure the cross sectional area, cross section and anteroposterior diameter of carpal tunnel entrance (pea bone plane) and carpal tunnel outlet (hook plane) before and after operation of median nerve in 46 cases of carpal tunnel syndrome. The swelling rate and flat rate of median nerve at the entrance and outlet of carpal tunnel before and after operation were calculated, as well as the changes of cross-sectional area, swelling rate and flat rate before and after operation. The early curative effect was evaluated 3 months after operation, and the correlation between the morphologic changes of median nerve before and after operation and the early curative effect was analyzed. The cross sectional area of the median nerve was decreased (0.196 鹵0.155) and the swelling rate was decreased (0.211 鹵0.131), and the cross sectional area of the median nerve at the outlet of the carpal tunnel was decreased (0.086 鹵0.241), the swelling rate was decreased (0.733 鹵0.096) and the flat rate was decreased (0.122 鹵0.082). The cross sectional area of the median nerve before and after operation was decreased (0.142 鹵0.190), the swelling rate was decreased (0.233 鹵0.285), the cross sectional area of the median nerve at the outlet of the carpal tunnel was decreased (0.087 鹵0.256), the swelling rate was decreased (0.052 鹵0.271) and the flat rate was decreased (0.760 鹵0.544). The two kinds of examination data showed significant changes in the shape of median nerve after carpal tunnel release. The changes of cross sectional area and swelling rate of carpal tunnel entrance area were significantly correlated with the early postoperative curative effect, and could be used as predictors of early postoperative curative effect.
【作者單位】： 安徽醫(yī)科大學(xué)第一附屬醫(yī)院;安徽醫(yī)科大學(xué)附屬安慶醫(yī)院;
【基金】：安徽省自然科學(xué)基金(1508085MH152)資助
【分類(lèi)號(hào)】：R688

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