肘管综合征病因学探讨与显微手术评价

发布时间：2018-10-11 09:54

【摘要】：目的：探讨肘管综合征的发病原因，显微手术治疗效果。方法：选取从2010~2014年，于本院手外科就诊的60例肘管综合征患者。所有患者皆行尺神经皮下前置术结合神经显微松解治疗。根据术中所探查的尺神经卡压位置及原因，综合分析诱因，合并肢体畸形等情况，，探讨肘管综合征发病原因。术前根据顾玉东所建议的肘管综合征临床分型标准对病例进行分级，术后随访采用肘管综合征功能评定标准，综合分析年龄、病程等因素，对手术疗效进行评价。结果：术中明确诊断尺神经卡压的位置及原因。根据肘管综合征临床分型评定标准，中度12例（12肢），重度48例（51肢）。随访时间3~18个月，其中优7例（7肢），良30例（32肢），可18例（18肢），差5例（6肢），术后优良率为61.9%。结论：综合本组病例发病原因，除文献报道的常见原因外，还有其他少见原因，包括骨质增生压迫，肿物压迫等。尺神经皮下前置术结合神经显微松解是治疗肘管综合征可靠的方法，年龄越小，病程越短，手内在肌萎缩情况较轻的患者术后功能恢复越好。
[Abstract]:Objective: to investigate the causes of cubital tunnel syndrome and the effect of microsurgery. Methods: from 2010 to 2014, 60 patients with cubital tunnel syndrome were selected. All patients were treated with subcutaneous anterior ulnar nerve surgery and microlysis. According to the location and cause of ulnar nerve compression, the causes of cubital tunnel syndrome were analyzed. According to the clinical classification standard of cubital tunnel syndrome suggested by Gu Yudong, the patients were classified before operation. The functional evaluation criteria of cubital tunnel syndrome were used for postoperative follow-up. The effect of operation was evaluated by comprehensive analysis of age, course of disease and other factors. Results: the location and cause of ulnar nerve compression were determined during operation. According to the clinical classification of cubital tunnel syndrome, 12 cases were moderate (12 limbs), 48 cases were severe (51 limbs). The follow-up time ranged from 3 to 18 months, including excellent 7 cases (7 limbs), good 30 cases (32 limbs), fair 18 cases (18 limbs) and poor 5 cases (6 limbs). The excellent and good rate was 61.9%. Conclusion: in addition to the common causes reported in the literature, there are other rare causes, including hyperosteogenesis and mass compression. Subcutaneous preposition of ulnar nerve combined with microlysis of nerve is a reliable method for the treatment of cubital tunnel syndrome. The younger the age, the shorter the course of disease, the better the functional recovery of the patients with mild hand muscle atrophy.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R688

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