在治疗手腕道综合征:一个随机对照试验手术对手术:一个随机对照试验
Annette A M Gerritsen1, Henrica C W de Vet, Rob J P M Scholten
1Institute for Research in Extramural Medicine, Vrije Universiteit Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. aam.gerritsen.emgo@med.vu.nl
JAMA
|September 7, 2002
概括
与手腕 splinting 相比,开放的手腕道释放手术为手腕道综合征 (CTS) 症状提供了优越的短期和长期缓解. 外科手术在改善一般健康和减少症状严重程度方面表现出更高的成功率.
科学领域:
- 神经学 神经学
- 整形外科手术 整形外科手术
- 临床试验 临床试验
背景情况:
- 带道综合征 (CTS) 提出了治疗挑战,没有关于最佳管理的最终共识.
- 存在非手术和手术干预,需要进行比较疗效研究.
研究的目的:
- 评估和比较手腕 splinting 的短期和长期有效性与开放的手腕道释放手术对CTS症状的缓解.
主要方法:
- 一项随机对照试验,涉及176名已确诊的异常性CTS患者.
- 患者被分配到夜间手腕 splinting (n=89) 或开放的手腕道释放 (n=87).
- 随机化后18个月进行了后续评估.
主要成果:
- 手术在3个月 (80%对54%) 和18个月 (90%对75%) 的成功率明显高于 splinting.
- 在手术和 splinting 之间成功率的差异在两个时间点都是统计学上显著的.
- 在 splinting 组中,显著比例 (41%) 的患者最终接受了手术.
结论:
- 开放的手腕道释放手术为被诊断为手腕道综合征的患者提供了卓越的结果.
- 在长期管理CTS症状方面,手术干预比手腕 splinting 更有效.
相关概念视频
01:13Randomized Experiments
The randomization process involves assigning study participants randomly to experimental or control groups based on their probability of being equally assigned. Randomization is meant to eliminate selection bias and balance known and unknown confounding factors so that the control group is similar to the treatment group as much as possible. A computer program and a random number generator can be used to assign participants to groups in a way that minimizes bias.
Simple randomization
Simple...
Simple randomization
Simple...
01:11Blinding
Blinding is a commonly used method of not telling participants which treatment a subject is receiving. Blinding is a critical part of a randomized control trial or RCT. It reduces the bias that affects the results. In an RCT, blinding is used in the form of a placebo. A placebo effect occurs when untreated subjects falsely believe they have received the treatment and report improved symptoms. A placebo or a dummy treatment is administered to subjects to negate the bias caused by such an effect.