Prevalence of carpal tunnel syndrome in a general population
Prevalence of carpal tunnel syndrome in a general population
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DOI：
10.1001/jama.282.2.153
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发表时间：
1999-07-14
影响因子：
120.7
通讯作者：
Rosén, I
中科院分区：
文献类型：
--
作者：
Atroshi, I;Gummesson, C;Rosén, I
腕管综合征（CTS）是手部疼痛、麻木和刺痛的原因，也是导致工作能力丧失的重要原因。虽然CTS在某些职业中的高患病率已被报道，但其在一般人群中的患病率知之甚少。目的估计CTS在一般人群中的患病率。设计1997年2月发送的一般健康邮件调查，询问身体任何部位的疼痛，麻木和刺痛症状，2个月后对报告手部正中神经分布症状的应答者进行临床检查和神经传导测试，以及那些没有报告这些症状的样本地点：瑞典南部一个地区，人口170000人。参与者：性别和年龄分层的3000名受试者（年龄范围，25-74岁）是从一般人口登记册中随机选择的，并发送了调查，答复率为83%（n = 2 466; 46%为男性）。在有症状的应答者中，81%接受了临床检查。主要结果测量人群患病率，计算方法为在检查中诊断为临床上确定的CTS和/或电生理正中神经病变的有症状应答者的数量除以应答者的总数。和/或手部正中神经分布刺痛（患病率，14.4%; 95%置信区间[CI]，13.0%-15.8%）。在临床检查中，94名有症状的受试者被诊断为患有临床确定的CTS（患病率，3.8%; 95% CI，3.1%-4.6%）。神经传导测试显示120名有症状受试者的腕管正中神经病变（患病率，4.9%; 95%CI，4.1%-5.8%），66名有症状受试者有临床和电生理证实的CTS（患病率，2.7%; 95%CI，2.1%-3.4%）。在125名对照者中，23例（18.4%，95%CI，12.0%~ 26.3%）出现正中神经病变。根据我们的数据，基于临床检查和电生理测试，预计1/5的有症状受试者患有CTS。
Context Carpal tunnel syndrome (CTS) is a cause of pain, numbness, and tingling in the hands and is an important cause of work disability. Although high prevalence rates of CTS in certain occupations have been reported, little is known about its prevalence in the general population.Objective To estimate the prevalence of CTS in a general population.Design General health mail survey sent in February 1997, inquiring about symptoms of pain, numbness, and tingling in any part of the body, followed 2 months later by clinical examination and nerve conduction testing of responders reporting symptoms in the median nerve distribution in the hands, as well as of a sample of those not reporting these symptoms (controls).Setting A region in southern Sweden with a population of 170 000.Participants A sex- and age-stratified sample of 3000 subjects (age range, 25-74 years) was randomly selected from the general population register and sent the survey, with a response rate of 83% (n = 2466; 46% men). Of the symptomatic responders, 81% underwent clinical examination.Main Outcome Measures Population prevalence rates, calculated as the number of symptomatic responders diagnosed on examination as having clinically certain CTS and/or electrophysiological median neuropathy divided by the total number of responders.Results Of the 2466 responders, 354 reported pain, numbness, and/or tingling in the median nerve distribution in the hands (prevalence, 14.4%; 95% confidence interval [CI], 13.0%-15.8%). On clinical examination, 94 symptomatic subjects were diagnosed as having clinically certain CTS (prevalence, 3.8%; 95% CI, 3.1%-4.6%). Nerve conduction testing showed median neuropathy at the carpal tunnel in 120 symptomatic subjects (prevalence, 4.9%; 95% CI, 4.1%-5.8%), Sixty-six symptomatic subjects had clinically and electrophysiologically confirmed CTS (prevalence, 2.7%; 95% CI, 2.1%-3.4%). Of 125 control subjects clinically examined, electrophysiological median neuropathy was found in 23 (18.4%; 95% CI, 12.0%-26.3%).Conclusion Symptoms of pain, numbness, and tingling in the hands are common in the general population. Based on our data, 1 in 5 symptomatic subjects would be expected to have CTS based on clinical examination and electrophysiologic testing.