内镜与开放的手腕道释放:对结果和并发症的系统审查
Ramkumar Rajapandian1, Sajida Moti Wala2, Esraa M Aledani2
1Trauma and Orthopedics, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Cureus
|August 21, 2024
概括
内镜道释放 (ECTR) 对道综合征提供了比开放式道释放 (OCTR) 更好的结果,恢复速度更快,并发症更少. 然而,ECTR需要更高的外科技能,并且具有更高的神经损伤风险.
科学领域:
- 整形外科 整形外科 整形外科
- 神经外科 神经外科
- 基于证据的医学是基于证据的医学.
背景情况:
- 手腕道综合征 (CTS) 是一种普遍的疾病,由手腕中枢神经的压缩引起.
- 手术干预,包括内镜手指道释放 (ECTR) 和开放手指道释放 (OCTR),旨在缓解CTS症状.
- 在ECTR和OCTR之间做出选择可以显著影响手术结果和并发症率.
研究的目的:
- 系统地审查和比较ECTR与OCTR治疗手掌道综合征的结果和潜在并发症.
- 为临床医生和患者提供基于证据的见解,以了解不同手腕道释放方法的有效性和安全性.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析以及比较ECTR和OCTR的元分析.
- 在PubMed,Science Direct和Google Scholar上进行文献搜索,查找2012年1月至2023年10月间发表的研究.
- 使用Cochrane风险偏差工具和AMSTAR 2评估研究质量;结果包括症状缓解,功能恢复和并发症.
主要成果:
- 在术后不适,功能恢复,握力,恢复工作和患者满意度方面,ECTR表现与OCTR相似或优于OCTR.
- 与OCTR相比,ECTR与痕敏感度,柱痛和伤口并发症的比率较低有关.
- 在ECTR中,可逆性神经损伤的风险更高,两种方法在其他并发症方面没有显著差异.
结论:
- 无论是ECTR还是OCTR,都是对手腕道综合征的安全有效治疗方法.
- ECTR提供了诸如更快的恢复和更好的化品效果等优势,但需要先进的外科手术能力,并带有神经损伤的风险.
- 手术技术的选择应该是个性化的,考虑患者的偏好,成本效益和外科医生的专业知识.
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