王新江+单海民+石宁宁

摘 要 目的：探讨鼠神经生长因子联合传统腕管切开减压松解术治疗腕管综合征的临床疗效。方法：收集腕管综合征患者32例为观察组，另选取30例为对照组，所有患者均行传统腕管切开减压松解术，观察组术后应用鼠神经生长因子。记录手术时间，观察患手创面愈合情况、术后血肿、术后并发症发生情况及术后恢复工作时间，比较手术前后Tinel征和Phalen征例数及患手两点辨别觉、握力、捏力值。结果：所有患者手术切口Ⅰ期愈合。观察组术后并发症发生率低于对照组。两组术后Tinel征和Phalen征阳性患者显著减少，辨别觉、握力值、捏力值与术前比较均显著改善。术后观察组SCV和SNAP均优于对照组。结论：鼠神经生长因子联合传统腕管切开减压松解术可明显改善腕管综合征患者的症状，改善其手部功能，尤其是对患者手部神经功能的改善，具有重要的促进意义。

关键词 鼠神经生长因子 传统腕管切开减压松解术 腕管综合征

中圖分类号：R977.6； R745 文献标识码：B 文章编号：1006-1533（2017）15-0042-03

Clinical effect of nerve growth factor combined with carpal tunnel release in the treatment of 32 cases of carpal tunnel syndrome

WANG Xinjiang， SHAN Haimin， SHI Ningning

（Department of Hand Micro Orthopedics， Luoyang Orthopaedic Hospital， Luoyang 471000， China）

ABSTRACT Objective： To investigate the clinical effect of nerve growth factor combined with traditional carpal tunnel decompression and relaxation in the treatment of carpal tunnel syndrome. Methods： A total of 32 patients with carpal tunnel syndrome were selected as an observation group， and another 30 cases as a control group. All patients underwent traditional carpal tunnel decompression and decompression while the observation group was additionally treated with nerve growth factor. The operation time， hand wound healing after hematoma， postoperative complications and the incidence of recovery time after surgery were recorded. The cases of Tinel syndrome and Phalen syndrome and 2-PD， hand grip and pinch force value were compared before and after the operation. Results： All patients underwent primary healing of incisions. The incidence of postoperative complications in the observation group was lower than that in the control group. The number of positive patients with Tinel sign and Phalen sign were significantly decreased in two groups， and the perceived strength， grip strength and pinch force were significantly improved compared with preoperation. The SCV and SNAP in the observation group were better than those in the control group after surgery. Conclusion： Mouse nerve growth factor combined with traditional open carpal tunnel decompression can significantly improve symptoms and hand function of patients with carpal tunnel syndrome， with important promotion significance especially to the improvement of hand nerve function of patients.

KEY WORDS mouse nerve growth factor； traditional carpal tunnel release； carpal tunnel syndrome

腕管综合征是最常见的周围神经卡压性疾病，主要表现为手指麻木、疼痛、感觉异常，拇对掌功能障碍、大鱼际萎缩等临床症状[1]。目前随着电脑办公的普及，其发病率明显增加。临床上对腕管综合征的治疗包括支具固定、皮质内固醇激素局部注射、非留体类抗炎药物口服等保守治疗和传统腕管切开减压松解术、小切口松解关节内镜下腕管切开减压松解术等手术治疗[2]。神经生长因子是具有调节损伤神经修复机能、促进神经损伤后再生的生物活性因子[3]，我院采用鼠神经生长因子联合传统腕管切开减压松解术治疗腕管综合征患者32例，疗效显著。……