中国组织工程研究

中国组织工程研究 ›› 2014, Vol. 18 ›› Issue (51): 8358-8364.doi: 10.3969/j.issn.2095-4344.2014.51.029

• 组织构建循证医学 evidence-based medicine in tissue construction • 上一篇    

有限小切口松解与常规切开松解修复腕管综合征的Meta分析

艾科热木•吾普尔，加莎热特•杰力勒，艾合买提江•玉素甫，阿不来提•阿不拉，阿布都黑力力•买买提艾力，刘亚飞，阿依娜孜，黄 勇，杨朋斐   

  1. 新疆医科大学第一附属医院显微修复外科，新疆维吾尔自治区乌鲁木齐市 830054
  • 出版日期:2014-12-10 发布日期:2014-12-10
  • 通讯作者: 加莎热特?杰力勒，副教授，副主任医师，硕士生导师，新疆医科大学第一附属医院显微修复外科，新疆维吾尔自治区乌鲁木齐市 830054
  • 作者简介:艾科热木?吾普尔，男，1988年生，新疆维吾尔自治区吐鲁番人，维吾尔族，新疆医科大学在读硕士，主要从事四肢创伤及显微修复重建的研究。
  • 基金资助:

    国家自然科学基金资助项目(81460337)

Meta-analysis of limited mini incision release and traditional open carpal tunnel release for treatment of carpal tunnel syndrome

Aikeremu Wupuer, Jiasharete Jielile, Aihemaitijiang Yusufu, Abulaiti Abula, Abuduheilili Maimaitiaili,     Liu Ya-fei, Ayinazi, Huang Yong, Yang Peng-fei   

  1. Department of Microsurgery and Reconstruction Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Online:2014-12-10 Published:2014-12-10
  • Contact: Jiasharete Jielile, Associate professor, Associate chief physician, Master’s supervisor, Department of Microsurgery and Reconstruction Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • About author:Aikeremu Wupuer, Studying for master’s degree, Department of Microsurgery and Reconstruction Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81460337

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摘要：

背景：自1991年以来，许多医师在使用腕横纹开放式小切口技术试图结合传统腕管切开松解的简单性和安全性减少组织损伤和术后复发率。但哪一种技术更具优势一直存在争议。
目的：对非内窥镜的有限小切口松解和传统腕管切开松解治疗腕管综合征的疗效进行系统评价。 
方法：按照 Cochrane 系统评价的方法，计算机检索MEDLINE(1966年1月至2010年3月)、EMBASE(1966年1月至2014年5月)、Cochrane图书馆(2014年5月)及中国生物医学文献数据库(1979年1月至2013年12月)，并手工检索相关的中英文骨科杂志。收集所有相关的随机对照试验，并评价纳入研究的方法学质量，采用Cochrane协作网提供的软件Revman5.2进行Meta分析，以获得有限小切口松解与传统腕管切开松解治疗腕管综合征的疗效及其安全性是否有差异的相关证据。
结果与结论：共纳入7个随机对照试验进行评价。Meta分析显示，有限小切口松解组与传统腕管切开松解组的瘢痕痛、柱状痛，主观满意率、治疗后恢复日常工作时间差异无显著性意义(P > 0.05)； 有限小切口松解组后并发症发生率和手术时间显著低于传统腕管切开松解组(P < 0.05)。结果表明，与传统腕管切开松解相比， 有限小切口松解可降低腕管综合征治疗后并发症，缩短手术时间；两种术式治疗后瘢痕痛率、柱状痛率、主观满意度、恢复日常工作时间差异无显著性。因研究质量及样本的局限性，此两种治疗方法与治疗后恢复时间、治疗后疼痛和手功能等指标的比较上有待进一步研究。



中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程


全文链接：

关键词: 组织构建, 组织工程, 腕管综合征, 有限小切口松解术, 传统松解术, 随机对照试验, Meta分析, 非内窥镜

Abstract:

BACKGROUND: Since 1991, many physicians try to combine the small open-incision along the wrist crease with traditional carpal tunnel release that is simple and safe to reduce tissue damage and recurrence rate. But what kind of techniques is superior has been controversial.
OBJECTIVE: To compare the efficacy and safety of limited mini incision (non-endoscopic) carpal tunnel release with traditional open carpal tunnel release for carpal tunnel syndrome.
METHODS: Based on Cochrane Systematic Review, we searched through the MEDLINE (1966-01/2010-03), EMBASE (1966-01/2014-05), Cochrane Library (2014-05) and CBM disc (1979-01/2013-12), and relevant  seven Chinese and English orthopedic journals by hand. Then, we collected all the randomized control trials related to carpal tunnel syndrome. The quality of trials was critically assessed. The Revman5.2.2 that provided by Cochrane Collaboration was used for data management and analysis on the evidence of the difference in the efficacy and safety of limited mini incision carpal tunnel release versus traditional open carpal tunnel release.
RESULTS AND CONCLUSION: Totally seven randomized controlled trials were included by total retrieve and screening. The results of meta-analysis showed no significant differences in the scar tenderness, pillar pain, subjective satisfaction and recovery time between groups of limited mini incision carpal tunnel release and traditional open carpal tunnel release (P > 0.05). The rate of complications and operation time in group of limited mini incision carpal tunnel release were lower than those in group of traditional open carpal tunnel release (P < 0.05). Compared with the traditional open carpal tunnel release, the limited mini incision carpal tunnel release can reduce the rate of postoperative complications rate and operation time. There is no significant statistical difference in the rate of scar tenderness, pillar pain, subjective satisfaction and recovery time between the two approaches. However, owing to the limitations of study quality and sample size, the relationship of the surgical approaches with recovery time, postoperative pain and hand grip and pinch needs further studies.



中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程


全文链接：

Key words: carpal tunnel syndrome, pain, joint capsule release

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