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对手腕道综合征的挑性测试的解释变化

Floor A Davids¹, Sina Ramtin¹, Amin Razi¹

¹Department of Orthopedic Surgery, Dell Medical School, The University of Texas at Austin, Austin, TX.

The Journal of hand surgery

|August 14, 2024

概括

外科医生经常忽视手腕道综合征,当患者报告没有麻木感的疼痛时. 这可能导致误诊,影响中介神经病变的治疗.

科学领域:

整形外科手术整形外科手术
神经学神经学
医学诊断医学诊断医学诊断

背景情况:

手腕道综合征 (CTS) 诊断依赖于特征性症状,主要是麻醉.
疼痛作为CTS诊断中的主要症状的作用在专家之间进行了辩论.

研究的目的:

为了研究上肢外科医生如何在手腕道综合征的临床试验中解释特定症状.
为了确定在多大程度上疼痛,没有麻醉,被认为是中介神经病变的迹象由外科医生.

主要方法:

一个基于场景的实验,涉及上肢外科医生.
外科医生审查了不同患者人口统计和症状表现的临床细节.
关键变异包括主要症状,挑性测试反应 (,疼痛) 和症状位置.

主要成果:

在挑性测试 (Phalen,Durkan,Tinel) 期间的疼痛与外科医生将测试解释为负的相关.
整个手中的症状位置,而不是中枢神经分布,也导致了负面的解释.
这些发现表明,没有麻醉的疼痛不被专家认为是CTS的特征.

结论:

专家通常不认为没有麻醉症或非中枢神经分布症状的疼痛是手腕道综合征的特征.
认识到这种诊断偏差可以帮助预防中介神经病变的过度/不足诊断和过度治疗/不足治疗.
对这些诊断细微差别的认识对于准确的CTS管理和考虑心理社会因素至关重要.

关键词:

手管道综合征是什么意思诊断诊断诊断诊断诊断诊断疼痛疼痛疼痛疼痛麻醉症麻醉症麻醉症挑性测试试验挑性测试试验

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