腕管综合征术后正中神经形态变化研究分析

发布时间：2018-08-29 09:30

【摘要】：目前缺乏腕管综合征术后正中神经形态变化的定量研究,以及形态变化指标对术后评估的作用。本研究通过观察腕管综合征正中神经术前术后形态学改变情况,并探讨正中神经形态学变化指标与早期疗效的相关性。应用高频超声和磁共振测量46例腕管综合征正中神经术前及术后腕管入口(豌豆骨平面)、腕管出口(钩骨钩平面)的横截面积及横截面的横径和前后径,计算出术前术后正中神经在腕管入出口的肿胀率和扁平率,以及术前术后横截面积、肿胀率和扁平率的变化值。术后3个月对其早期疗效进行评分,并将术前术后正中神经的形态学变化指标与术后早期疗效进行相关性分析。高频超声检查正中神经术后入口区横截面积较术前减小(0.196±0.155)%,肿胀率减小(0.211±0.131)%;腕管出口区正中神经横截面积较术前减小(0.086±0.241)%,肿胀率减小(0.733±0.096)%,扁平率减小(0.122±0.082)%。磁共振检查正中神经术前术后入口区横截面积较术前减小(0.142±0.190)%,肿胀率减小(0.233±0.285)%;腕管出口区正中神经横截面积较术前减小(0.087±0.256)%,肿胀率减小(0.052±0.271)%,扁平率减小(0.760±0.544)%。两种检查数据均显示出腕管松解术后正中神经形态有显著变化,腕管入口区横截面积及肿胀率变化与术后早期疗效有显著相关性,可作为术后早期疗效的预测指标。
[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 卤0.155) and the swelling rate was decreased (0.211 卤0.131), and the cross sectional area of the median nerve at the outlet of the carpal tunnel was decreased (0.086 卤0.241), the swelling rate was decreased (0.733 卤0.096) and the flat rate was decreased (0.122 卤0.082). The cross sectional area of the median nerve before and after operation was decreased (0.142 卤0.190), the swelling rate was decreased (0.233 卤0.285), the cross sectional area of the median nerve at the outlet of the carpal tunnel was decreased (0.087 卤0.256), the swelling rate was decreased (0.052 卤0.271) and the flat rate was decreased (0.760 卤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.
【作者单位】：安徽医科大学第一附属医院;安徽医科大学附属安庆医院;
【基金】：安徽省自然科学基金(1508085MH152)资助
【分类号】：R688

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