CAJ | 학술논문

目的介绍腕管综合征内窥镜手术(endoscopic carpal tunnel release,ECTR)预防正中神经损伤并发症的方法.方法利用彩色多普勒超声仪(B超)对37例74手患者术前进行检测.结果 71例正中神经走行在桡侧腕屈肌腱与掌长肌腱之间,3例走行在掌长肌腱与尺侧腕屈肌腱之间,并术中确认.结论正中神经变异走行在掌长肌腱与尺侧腕屈肌腱之间是ECTR的禁忌证,B超能准确定位正中神经与掌长肌腱关系,避免内窥镜手术损伤正中神经,更具有简单、经济、方便可靠等优点.
목적 개소완관종합정내규경수술(endoscopic carpal tunnel release,ECTR)예방정중신경손상병발증적방법.방법 이용채색다보륵초성의(B초)대37례74수환자술전진행검측.결과 71례정중신경주행재뇨측완굴기건여장장기건지간,3례주행재장장기건여척측완굴기건지간,병술중학인.결론 정중신경변이주행재장장기건여척측완굴기건지간시ECTR적금기증,B초능준학정위정중신경여장장기건관계,피면내규경수술손상정중신경,경구유간단、경제、방편가고등우점.
Objective To introduce a method of preventing median never injury during endoscopic carpal tunnel release (ECTR). Methods Ultrasonography of both wrists was done to 37 patients of carpal tunnel syndrome who were going to undergo open release of the transverse carpal ligament. Structures in the carpal tunnel were visualized to guide surgical decision-making. Results Ultrasonography showed that median never lies between the tendon of flexor carpi radialis and palmaris longus in 71 patients and lies between the tendon of palmaris longus and flexor carpi ulnaris in 3 patients. These findings were confirmed during the surgeries. Conclusion It is a contraindication of ECTR if median never lies between palmaris longus and flexor carpi ulnaris. Ultrasonography can accurately reveal the relative position of median never to the palmaris longus tendon. Pre-operative ultrasonography of the wrist is a simple, inexpensive and convenient method to exclude these contraindications and thus prevent median never injuries in ECTR.