CAJ | 학술논문

目的探讨术中高频超声在不同程度腕管综合征松解手术治疗中的临床意义.方法对38例不同程度腕管综合征(CTS)患者术中进行高频超声检测,观察腕管内正中神经形态在术前及术中的变化,测量各断面正中神经的横截面积(CSA)及前后径.结果术中高频超声观察到术前超声显示的正中神经受压位点在行神经松解术后消失.对中度CTS患者,正中神经厚度比(TR)在术前与术中的差异有统计学意义(P=0.002).对重度患者,CSA-O及TR在术前与术中的差异均有统计学意义(P值分别为0.032、0.002).结论运用高频超声可判断术中正中神经受压部位是否解除.对于中重度CTS患者,术中高频超声测量的TR可用于对正中神经松解效果的评价.
목적 탐토술중고빈초성재불동정도완관종합정송해수술치료중적림상의의.방법 대38례불동정도완관종합정(CTS)환자술중진행고빈초성검측,관찰완관내정중신경형태재술전급술중적변화,측량각단면정중신경적횡절면적(CSA)급전후경.결과 술중고빈초성관찰도술전초성현시적정중신경수압위점재행신경송해술후소실.대중도CTS환자,정중신경후도비(TR)재술전여술중적차이유통계학의의(P=0.002).대중도환자,CSA-O급TR재술전여술중적차이균유통계학의의(P치분별위0.032、0.002).결론 운용고빈초성가판단술중정중신경수압부위시부해제.대우중중도CTS환자,술중고빈초성측량적TR가용우대정중신경송해효과적평개.
Objective To explore the clinical value of intraoperative high-resolution ultrasonography during surgical decompression of carpal tunnel syndromes (CTS) with varying degrees of severity.Methods Thirty-eight patients with different degrees of CTS underwent ultrasonography (US) of the wrist preoperatively and during carpal tunnel release.The shape of the median nerve in the carpal tunnel and the cross-sectional area (CSA) and anteroposterior diameter of the nerve before the surgery and immediately after carpal tunnel release during the surgery were compared.Results Intraoperative high-resolution ultrasonography revealed that the compression site of the median nerve identified by the preoperative ultrasonography disappeared after carpal tunnel decompression.For moderate CTS,median nerve thickness ratio (TR) was significantly different between preoperative US measurement and intraoperative measurement (P =0.002).For severe CTS,CSA and TR showed significant differences between preoperative and intraoperative measurements (P =0.032 and 0.002,respectively).Conclusion Intraoperative high-resolution ultrasonography may be considered as a complementary tool to observe the complete or incomplete release of median nerve compression site.For moderate and severe carpal tunnel syndrome,TR can be used to evaluate the effect of intraoperative median nerve decompression.