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手腕道综合征的手术与皮质类固醇注射 (DISTRICTS):一个开放的,多中心的,随机对照试验
Wijnand A C Palmbergen1, Roy Beekman2, A Marijne Heeren3
1Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Department of Neurology, BovenIJ Hospital, Amsterdam, Netherlands.
Lancet (London, England)
|June 14, 2025
概括
与皮质类固醇注射相比,手腕道综合征开始手术的恢复率在18个月内更高. 这项随机试验强调手腕道综合征患者的手术作为更有效的初步方法.
科学领域:
- 整形医学
- 神经学
- 临床试验
背景情况:
- 手腕道综合征 (CTS) 是一种常见的影响手腕中枢神经的疾病.
- 已建立的治疗方法包括手术和皮质类固醇注射,但最优的初始策略仍在争论中.
研究的目的:
- 为了比较手腕道综合征治疗的有效性与皮质类固醇注射.
- 确定每种治疗方法的18个月的恢复率.
主要方法:
- 一个开放的,随机的受控试验,涉及31个荷兰医院的934名参与者.
- 已确诊的CTS患者被随机 (1:1) 分给手术或皮质类固醇注射作为初始治疗.
- 主要结论是18个月后康复的患者比例 (在6项CTS尺度上定义为分数< 8).
主要成果:
- 手术组:61%的康复率 (243/ 401) 与注射组:45%的康复率 (180/ 404) 在18个月.
- 手术显示出明显更高的康复率 (相对风险为1. 36; p< 0. 0001).
- 不良事件在各组之间相似 (86% 的手术与 85% 的注射);手术组的一次住院治疗.
结论:
- 与皮质类固醇注射相比,手腕道综合征的手术治疗提供了显著更高的恢复可能性.
- 即使允许后续干预,这种情况也是如此.
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