可视化针刀松解腕横韧带对腕管纤维化影响的机制研究

腕管综合征是最常见的周围神经卡压性疾病，腕横韧带增厚是导致腕管综合征的重要原因。我们前期研究已经证实了经典针刀术式的危险性和超声引导针刀治疗的安全性及有效性，并在临床观察发现可视化针刀松解腕横韧带在改善腕管综合征患者的临床症状效果明显。其机制可能是通过可视化精准松解腕横韧带，减少损伤，改变腕横韧带生物力学特性，降低腕管纤维化表达，进而发挥其临床功效。本研究先利用新西兰兔腕管综合征模型进行术式优化，再通过超声引导下对新西兰兔腕管综合征模型进行针刀松解，与糖皮质激素注射操作进行对照，以术后不同时间节点正中神经功能、腕管横截面积指标、韧带力学性质、炎症介质等为研究内容，运用影像学、形态学观察、免疫组化等方法开展研究，以揭示可视化针刀切割腕横韧带减少损伤及改善腕管微环境机制间的关系。同时通过临床研究可视化针刀治疗对患者远期疗效。综上研究为临床应用可视化针刀治疗腕管综合征提供理论依据。

Carpal tunnel syndrome is the most common peripheral nerve compression disease. Thickening of the transverse carpal ligament is an important cause of carpal tunnel syndrome. Our previous studies have confirmed the dangers of classic acupotomy and the safety and effectiveness of ultrasound-guided acupotomy treatment. In clinical observation, we have found that visualized acupotomy can improve the clinical symptoms of patients with carpal tunnel syndrome. The effect is obvious. The mechanism may be to loosen the transverse carpal ligament accurately through visualization, reduce damage, change the biomechanical properties of the transverse carpal ligament, reduce the expression of carpal tunnel fibrosis, and then exert its clinical effect. In this study, the New Zealand rabbit carpal tunnel syndrome model was used to optimize the surgical procedure, and then the New Zealand rabbit carpal tunnel syndrome model was released by needle knife under the guidance of ultrasound, and the operation was compared with the glucocorticoid injection operation. Median nerve function, carpal tunnel cross-sectional area indicators, ligament mechanical properties, inflammatory mediators, etc. are the research contents. Research is carried out using imaging, morphological observation, immunohistochemistry and other methods to reveal that the visual needle knife cuts the transverse carpal ligament to reduce damage and Improve the relationship between the carpal tunnel microenvironmental mechanisms. At the same time, the long-term effect of needle knife treatment on patients is visualized through clinical research. In summary, the research provides a theoretical basis for the clinical application of visualized needle knife to treat carpal tunnel syndrome.