Observation on clinical efficacy of minimally invasive surgery combined with hyperbaric oxygen in 42 cases of moderate to severe carpal tunnel syndrome
10.3760/cma.j.cn311847-20210312-00084
- VernacularTitle:微创手术联合高压氧辅助治疗中重度腕管综合征42例疗效观察
- Author:
Haojie ZHANG
1
;
Hui WANG
;
Honglei CHEN
;
Zhanchao WANG
;
Jiye HE
;
Qiang ZHOU
Author Information
1. 202150 上海，上海交通大学医学院附属新华医院崇明分院骨科
- Publication Type:Journal Article
- Keywords:
Minimally invasive surgery;
Hyperbaric oxygen;
Carpal tunnel syndrome
- From:
Chinese journal of nautical medicine and hyperbaric medicine
2021;28(3):283-287
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of minimally invasive surgery combined with hyperbaric oxygen in the treatment for moderate to severe carpal tunnel syndrome.Methods:The clinical data of 86 patients with moderate to severe carpal tunnel syndrome admitted to the Department of Adult Orthopedics of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the Orthopedics Department of the Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from March 2016 to December 2019 were retrospectively analyzed. According to the treatment method, they were divided into observation group ( n=42) and control group ( n=44). The control group was treated with modified Okutsu method of endoscopic carpal tunnel release (ECTR), and the observation group was given hyperbaric oxygen on the basis of the treatment in the control group. The clinical efficacy of the two groups three months after operation was assessed by using carpal tunnel syndrome evaluation criteria, and their excellent and good recovery rates were compared. The median nerve sensory conduction velocity (SCV), motor nerve conduction velocity (MCV), sensory nerve action potential (SNAP) amplitude, and motor nerve distal motor latency (DML) of the two groups were measured by electromyography before operation, and 14 d, 30 d, and 90 d after operation. The disabilities of arm, shoulder, and hand (DASH) questionnaire was used to evaluate the upper-extremity function of the two groups before operation, and 14 d, 30 d, and 90 d after operation, and the pinch strength and grip strength of the two groups before operation, and 14 d, 30 d and 90 d after operation were measured by Jamar Pinch Gauge and Jamar Hand Dynamometer. Results:After three months of follow-up, the excellent and good recovery rate of the observation group (85.71%) was significantly higher than that of the control group (70.45%), with a significant statistical difference ( P<0.05). The DASH scores of the observation group were significantly lower than those of the control group at 14 d, 30 d, and 90 d after operation ( P<0.05). The SCV and MCV of the observation group were significantly faster than those of the control group at 14 d, 30 d, and 90 d after operation ( P<0.05). The DMLs of the observation group were significantly shorter than those of the control group at 14 d, 30 d, and 90 d after operation, while the SNAPs were significantly bigger than those of the control group ( P<0.05). The grip strength and pinch strength of the observation group were significantly stronger than those of the control group at 14 d, 30 d, and 90 d after operation ( P<0.05). Conclusion:Modified Okutsu method of ECTR combined with postoperative hyperbaric oxygen treatment can improve the clinical excellent and good recovery rate of carpal tunnel syndrome, which can enhance the electrophysiological function of their median nerves, and their daily functioning, to provide reference for treating chronic injuries caused by carpal tunnel syndrome and other peripheral nerve entrapment syndromes.
