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在类风湿性关节炎中后部骨内神经麻:系统性审查
Brooke Kowalski1, Nicholas J Zarkadis2, Mitchell Harris2
1Madigan Army Medical Center, Joint Base Lewis-McChord, WA, USA.
概括
类风湿性关节炎 (RA) 可以导致后骨间神经 (PIN) ,经常出现肘部疼痛和手指延伸软弱. 手术减压对于持久病例是有效的,大多数患者康复良好.
科学领域:
- 整形外科 整形外科 整形外科
- 类风湿病学 类风湿病学
- 神经学 神经学
背景情况:
- 类风湿性关节炎 (RA) 是一种全身性自身免疫性疾病.
- 后骨内神经 (PIN) 麻可能发生在RA患者中.
- 了解RA中的PIN对于患者管理至关重要.
研究的目的:
- 在RA患者中系统地审查PIN麻的病理解剖学,表现,诊断,治疗和结果.
- 整合现有的案例数据,以获得全面的概述.
- 在RA的背景下,确定PIN的最佳管理策略.
主要方法:
- 在RA患者中报告的PIN麻病例的系统审查.
- 包括70名患者中的72例病例.
- 对临床表现,诊断发现和治疗结果的分析.
主要成果:
- 在RA中PIN麻影响女性比男性 (1:2.7比).
- 常见的症状包括肘部疼痛 (20/33) 和手指延伸软弱 (27/33).
- 手术减压显示出高的成功率,只有1例持续的弱点病例 (1/54) 在保守的管理失败后.
结论:
- 保守的治疗 (药物治疗,MRI/超声波) 对于一些与RA相关的PIN麻病例是适当的.
- 对于压缩性病理不响应6周的保守治疗或在晚期呈现时,建议进行外科解压.
- 早期的手术干预可以在某些患有PIN的RA患者中带来良好的结果.
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