超声可视化针刀治疗腕管综合征的安全性及临床疗效观察

Observation on the Safety and Clinical Efficacy of Ultrasound Visualization Needle Knife Treatment for Carpal Tunnel Syndrome

摘要: 背景：腕管综合征是一种常见的神经卡压综合征，针刀治疗本病具有不可替代的地位，但其安全性和有效性有进一步提升的空间，超声可视化针刀技术是实现该目的的有效途径。目的：通过比较超声可视化针刀技术与传统针刀疗法治疗腕管综合征的疗效观察，从而突出超声可视化针刀治疗腕管综合征的临床疗效及安全性。方法：选取2021年5月~2023年5月的60例于新医大一附院昌吉分院针灸推拿科门诊及病区的CTS患者。随机分为观察组和对照组，两组各30例，其中采用超声可视化针刀技术治疗的设为观察组，另一组采用传统针刀治疗设为对照组，两组均为每周1次治疗，共治疗4周。评价指标通过观察治疗前后两组患者的Levine腕管综合征评分、两组患者VAS视觉模拟评分分数、测量两组患者治疗前后豌豆骨水平腕横韧带厚度TTCL，观察并记录整个试验治疗过程中出现的不良事件。结果：1) 治疗前两组患者的Levine腕管综合征评分、VAS视觉模拟评分、豌豆骨水平TTCL显示无统计学差异(P > 0.05)。2) 治疗后两组患者的Levine评分、VAS评分、TTCL较治疗前下降(P < 0.05)，观察组的Levine评分、VAS评分、TTCL均低于对照组，差异具有统计学意义(P < 0.05)。3) 试验过程中，观察组无不良事件，对照组出现1例不良事件。结论：超声可视化针刀技术与传统针刀疗法相比较，超声可视化针刀疗效更显著，且具安全保障，值得临床推广。

Abstract: Background: Carpal tunnel syndrome is a common nerve entrapment syndrome, and needle knife therapy plays an irreplaceable role in this disease. However, there is room for further improvement in its safety and effectiveness. Ultrasound visualization needle knife technology is an effective way to achieve this goal. Objective: To evaluate the safety and clinical efficacy of ultrasound visualization needle knife technique in the treatment of carpal tunnel syndrome. Methods: From May 2021 to May 2023, 60 patients diagnosed as CTS in the outpatient department and ward of acupuncture and moxibustion and Massage Department of Changji Branch of the First Affiliated Hospital of New Med-ical University were selected. According to a random number table, 30 patients were divided into a control group and an observation group in a 1:1 ratio. The control group received traditional needle knife therapy, while the observation group received ultrasound visualization needle knife therapy once a week. The treatment was completed four consecutive times. The efficacy evaluation selected VAS visual simulation score, Levine carpal tunnel syndrome score, and pea bone level transverse carpal ligament thickness TTCL to record adverse events and compare clinical efficacy. Result: 1) Before treatment, there was no statistically significant difference in VAS visual simulation score, Levine carpal tunnel syndrome score, and pea bone level TTCL between the two groups (P > 0.05). 2) After treatment, the VAS visual simulation score, Levine carpal tunnel syndrome score, and pea bone level TTCL of the two groups decreased compared to before treatment (P < 0.05). The VAS vis-ual simulation score, Levine carpal tunnel syndrome score, and pea bone level TTCL of the observa-tion group were lower than those of the control group, and the difference was statistically significant (P < 0.05). 3) One adverse event occurred in the control group, while no adverse event was observed in the observation group. Conclusion: Needle knife treatment for carpal tunnel syndrome can effec-tively improve clinical symptoms, while ultrasound visualization needle knife technology has a sig-nificant therapeutic effect on carpal tunnel syndrome, which is more safe and worthy of clinical ap-plication and promotion.