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在肘部治疗节神经病变的治疗方法

Pietro Caliandro¹, Giuseppe La Torre², Roberto Padua³

¹Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

The Cochrane database of systematic reviews

|April 29, 2025

概括

肘部神经病 (UNE) 治疗,包括手术和保守治疗,在改善功能方面表现出类似的有效性. 证据表明,各种外科手术技术之间差异很小,并突出说明糖注射在轻度至中度UNE中缓解疼痛的潜在益处.

科学领域:

神经学神经学
手术创新在外科创新.
基于证据的医学基于证据的医学.

背景情况:

肘部的神经病变 (UNE) 是一种常见的陷神经病变.
对于UNE的最佳治疗策略仍然是正在进行的辩论的主题.
本综述是对2011年,2012年和2016年之前分析的更新.

研究的目的:

评估UNE保守和手术干预措施的有效性和安全性.
为了确定手术治疗是否改善症状,征兆和神经功能.
评估保守治疗是否产生类似的益处,并确定最佳治疗选择的预测因素.

主要方法:

随机对照试验 (RCT) 和准RCT的系统审查和元分析.
搜索了多个数据库,直到2022年7月,搜索有关UNE治疗的相关研究.
提取了关于临床,神经生理和成像结果的数据,评估了使用GRADE的偏差风险和证据确定性.

主要成果:

在简单的减压和转位手术 (肌下/皮下) 之间,功能改善或并发症没有显著差异.
内镜解压显示了与开放式解压相比,可比的临床结果和并发症率.
有限的证据表明,糖注射对疼痛有潜在的益处,对轻度病例给予保守的建议.

结论:

低至中等确定性证据表明,在UNE中,不同外科解压技术的结果是可比的.
中等确定性证据表明,内镜和开放式减压之间没有显著差异.
保守治疗的有效性,如类固醇注射和患者教育,需要进一步调查.

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