The Effectiveness of Ultrasound-Guided Steroid Injection Combined with Miniscalpel-Needle Release in the Treatment of Carpal Tunnel Syndrome vs. Steroid Injection Alone: A Randomized Controlled Study
The Effectiveness of Ultrasound-Guided Steroid Injection Combined with Miniscalpel-Needle Release in the Treatment of Carpal Tunnel Syndrome vs. Steroid Injection Alone: A Randomized Controlled Study
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超声引导类固醇注射联合小手术刀松针治疗腕管综合征与单独类固醇注射的有效性：一项随机对照研究
DOI：
10.1155/2019/9498656
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发表时间：
2019-02
影响因子：
--
通讯作者：
Ma Chao
中科院分区：
文献类型：
--
作者：
Zhang Subo;Wang Fei;Ke Songjian;Lin Caina;Liu Cuicui;Xin Wenjun;Wu Shaoling;Ma Chao
目的腕管综合征（CTS）是最常见的神经卡压综合征之一，严重影响患者的工作和生活。最有效的保守治疗方法是类固醇注射，但其长期疗效仍不理想。本研究的目的是评价在超声引导下类固醇注射联合微型calpel针（MSN）释放治疗CTS与单纯类固醇注射的有效性。我们假设联合治疗可能更有益。方法将51例CTS患者随机分为激素注射联合MSN松解组和激素注射组。分别于治疗前、治疗后4周、12周采用波士顿腕管问卷（BCTQ）、正中神经横截面积（CSA）、远端运动潜伏期（DML）、复合肌肉动作电位（CMAP）、感觉神经动作电位（SNAP）、感觉神经传导速度（SNCV）4项电生理指标评价疗效。结果两组患者术后4周、12周各项指标均较治疗前改善，差异有统计学意义（P<0.05）。治疗12周后，激素注射联合MSN松解组BCTQ、DML、CMAP、SNCV、正中神经CSA评分均优于激素注射组（P<0.05）。结论激素注射联合MSN松解治疗CTS的疗效优于单纯激素注射，具有上级临床应用价值。该中国临床试验注册号为ChiCTR 1800014530。
Objectives Carpal tunnel syndrome (CTS) is one of the most common nerve entrapment syndromes, which has a serious impact on patients' work and life. The most effective conservative treatment is steroid injection but its long-term efficacy is still not satisfactory. The aim of this study was to evaluate the effectiveness of steroid injection combined with miniscalpel-needle (MSN) release for treatment of CTS under ultrasound guidance versus steroid injection alone. We hypothesized that combined therapy could be more beneficial. Methods Fifty-one patients with CTS were randomly allocated into two groups, namely, steroid injection combined with MSN release group and steroid injection group. The therapeutic effectiveness was evaluated using Boston Carpal Tunnel Questionnaire (BCTQ), cross-sectional area (CSA) of the median nerve, and four electrophysiological parameters, including distal motor latency (DML), compound muscle action potential (CMAP), sensory nerve action potential (SNAP), and sensory nerve conduction velocity (SNCV) at baseline, 4 and 12 weeks after treatment. Results Compared with baseline, all the parameters in both groups showed statistically significant improvement at week 4 and week 12 follow-up, respectively (P<0.05). When compared with steroid injection group, the outcomes including BCTQ, DML, CMAP, SNCV, and CSA of the median nerve were significantly better in steroid injection combined with MSN release group at week 12 after treatment (P<0.05). Conclusions The effectiveness of steroid injection combined with MSN release for CTS is superior to that of steroid injection alone, which may have important implications for future clinical practice. This Chinese clinical trial is registered with ChiCTR1800014530.
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DOI：
10.1177/1753193416671102
发表时间：
2017-03
期刊：
Journal of Hand Surgery (European Volume)
影响因子：
--
作者：
A. Hameso;J. Bland
通讯作者：
A. Hameso;J. Bland
影响因子：
27.4
作者：
Atchia, Ismael;Kane, David;Birrell, Fraser
通讯作者：
Birrell, Fraser
影响因子：
3.3
作者：
Lue, Yi-Jing;Lu, Yen-Mou;Liu, Ya-Fen
通讯作者：
Liu, Ya-Fen
影响因子：
2.3
作者：
Scanlon, Andrew;Maffei, Jennifer
通讯作者：
Maffei, Jennifer
影响因子：
2.3
作者：
J. Mcshane;S. Slaff;J. Gold;L. Nazarian
通讯作者：
J. Mcshane;S. Slaff;J. Gold;L. Nazarian