梁粤珩 付记乐 高峻青

【摘要】 目的：探討291例腕管综合征（CTS）的发病相关因素及分析诊治疗效。方法：2008年

1月-2015年12月，本院收治的291例CTS住院患者，男61例，女230例；年龄22～77岁，平均54.5岁。针对患者的一般情况、既往病史、职业、性别、手部专科情况及愈后等相关因素进行调查，总结CTS的相关发病因素及愈后。结果：分析显示女性CTS发病率明显高于男性（3.77︰1），家庭主妇占48.5%（141例），40～59岁为CTS高发年龄段占62.9%（183例），病程3年以内占73.2%（213例），其中合并颈椎病患者占27.5%（80例）。有夜间手部麻醒病史占79.4%（231例），Tinel征阳性66.3%（193例）和Phalen试验阳性62.5%（182例），肌电图检查神经重度损伤57.4%（167例），统计显示不同职业、手别、年龄、合并病史患者的CTS发病率无显著差异。推断性统计分析结果提示CTS病程与疾病严重程度差异有关，病程越长，病情会相应严重。而不同性别和年龄组之间病情严重程度差异无统计学意义。166例手术治疗，术后痊愈或症状缓解，无复发。而保守治疗的125例患者，仅3例痊愈，122例患者可缓解症状，后多数反复发作。结论：CTS具有明显的易患因素，其发病与多种因素密切相关；病程迁延，病情会相应加重，手术是治疗CTS的有效途径。

【关键词】 腕管综合征； 相关因素； 治疗； 效果

【Abstract】 Objective：To investigate the related factors of diagnosis and treatment of carpal tunnel syndrome（CTS）.Method：From January 2008 to December 2015，291 patients with carpal tunnel syndrome were enrolled in this study.There were 61 males and 230 females，aged from 22 to 77 years old （mean 54.5 years old）.In view of the general condition of the patients，the previous medical history，occupation，sex，hand specialist and other related factors were investigated，the relevant factors of carpal tunnel syndrome and prognosis were summarized.Result：Analysis showed that the incidence of CTS in women was significantly higher than that in men（3.77︰1）， housewives accounted for 48.5%（141 cases），40-59 years old was CTS high age group（183 patients，62.9%），213 patients（73.2%） were within 3 years，80 cases（27.5%） were complicated with cervical spondylosis.231 patients（79.4%） had history of awakening at night，there were 193 cases（66.3%） of positive Tinel sign and 182 cases（62.5%） of positive Phalen test.Ectromyogram was 167 cases（57.4%） with severe neurological injury.But occupation，different hand，age and past medical history did not significantly affect the incidence of the CTS.Inferred statistical analysis of the results suggested that CTS duration and severity of the disease，the longer the duration of the disease will be correspondingly serious.There was no significant difference in the severity of illness between different genders and age groups.166 cases of surgical treatment，postoperative recovery or symptoms，no recurrence.Conservative treatment of 125 cases，3 cases of recovery，the remaining patients can relieve symptoms，the majority of repeated attacks.Conclusion：Carpal tunnel syndrome has obvious risk factors，and its incidence is closely related to many factors.The longer the course is，the severity of the disease is correspondingly increased.The operation is an effective way to treat the carpal tunnel syndrome.

【Key words】 Carpal tunnel syndrome； Related factors； Treatment； Efficacy

First-authors address：Foshan Hospital of Traditional Chinese Medicine，Foshan 528000，China

doi：10.3969/j.issn.1674-4985.2018.33.004

腕管综合征（carpal tunnel syndrome，CTS）是腕管内各种原因导致正中神经受压而产生的一系列手部症状和功能障碍，是临床上最为常见的周围神经卡压性疾病，近年来其发病率逐渐上升[1-2]。其发病率与性别、年龄、职业、手别等因素密切相关，国内外学者研究表明女性及从事手工工作者是CTS的主要发病人群[3-5]。调查CTS的发病相关因素及诊治疗效，可以对患病人群进行早期诊断及积极治疗，减轻痛苦及避免神经损伤并发症，降低致残率具有重要的意义。……