针刀治疗腕管综合征新术式的临床解剖学研究

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摘要目的探讨针刀治疗腕管综合征新术式的安全性及准确性，为临床治疗提供解剖学依据。方法选取10%福尔马林防腐固定的成人标本26例（男15例，女11例），年龄60～90岁，平均（69.30±15.33）岁，共52侧（其中有2侧无法实验），标本来源于北京大学基础医学院遗体捐献中心，研究时间为2017年11月～2018年5月。在人体标本上模拟针刀松解腕横韧带操作，对两处进针点测量并计算其安全性及准确性数值。结果安全性：针刀松解痕迹距离正中神经的最短横向距离L1和L2分别为（3.26±0.82）mm（2.13～5.85 mm）和（3.19±0.73）mm（2.04～5.45 mm），未发现明显正中神经损伤。针刀松解离尺动脉横向最短距离L3和L4分别为（3.89±1.17）mm（1.95～7.11 mm）和（3.95±1.14）mm（2.01～6.86 mm），未见尺动脉损伤。进针点1和进针点2的针刀松解深度H1和H2分别为（10.20±1.22）mm（6.56～12.79 mm）和（8.96±1.31）mm（5.73～12.01 mm），有6例在肌腱表面发现轻微划痕，肌腱损伤率为12.00%。准确性：39例松解成功，11例失败。松解痕迹长度为（3.52±0.78）mm（2.04～4.89 mm）。松解总体成功率为78.00%。结论针刀松解腕横韧带治疗腕管综合征新术式的操作安全性较高，但由于其是盲视操作，准确性仍待提升。

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	周俏吟1
	2 申毅锋1
	2 贾雁1
	2 邱祖云1
	2 孙小洁1
	2 王建伟3 张卫光3 李石良1

关键词 ：针刀, 腕管综合征, 解剖, 治疗

Abstract：Objective To explore the safety and accuracy of the new surgical method of needle-knife in the treamtent of carpal tunnel syndrome, and provide anatomical basis for clinical treatment. Methods Twenty-six adult specimens (15 males and 11 females) of 10% formalin-preserved fixed specimens, aged 60-90 years, with an average of (69.30±15.33) years old, total 52 sides (two of them could not be tested). The specimen was collected from the Donation Center of Peking University School of Basic Medicine. The research period was from November 2017 to May 2018. The operation of acupotomology to release the transverse wrist ligament was simulated in human specimens, and the safety and accuracy values of the two needle points were measured and calculated. Results Safety: The shortest lateral distances L1 and L2 of the released marks by needle-knife from the median nerve were (3.26±0.82) mm (2.13-5.85 mm) and (3.19±0.73) mm (2.04-5.45 mm), respectively. No obvious median nerve injury was found. The shortest distances L3 and L4 of the the released marks by needle-knife from ulnar artery were (3.89±1.17) mm (1.95-7.11 mm) and (3.95±1.14) mm (2.01-6.86 mm), respectively. No ulnar artery injury was observed. The release depth H1 and H2 of needle-knife of the needle insertion point 1 and point 2 was (10.20±1.22) mm (6.56-12.79 mm) and (8.96±1.31) mm (5.73-12.01 mm), respectively, and shadow scratch was found on the surface of the tendon of 6 cases, the tendon injury rate was 12.00%. Accuracy: 39 cases were successful and 11 cases were failed. The length of the release trace was (3.52±0.78) mm (2.04-4.89 mm). The total success rate of release was 78.00%. Conclusion The operational safety of new surgical method of needle-knife in the treatment of carpal tunnel syndrome by releasing transverse carpal ligament is higher, but its accuracy remains to be improved because of its blind vision operation.

Key words： Needle-knife Carpal tunnel syndrome Anatomy Treatment

通讯作者: 张卫光（1970-），男，博士，教授，博士生导师；研究方向：临床解剖学。李石良（1963-），男，博士，主任医师，教授，博士生导师；研究方向：针刀医学基础与临床。

作者简介: 周俏吟（1992-），女，北京中医药大学2016级中日友好临床医学院针灸推拿学在读硕士研究生；研究方向：针灸推拿。

引用本文:

周俏吟1,2 申毅锋1,2 贾雁1,2 邱祖云1,2 孙小洁1,2 王建伟3 张卫光3 李石良1. 针刀治疗腕管综合征新术式的临床解剖学研究[J]. 中国医药导报, 2019, 16(9): 170-173.
ZHOU Qiaoyin1,2 SHEN Yifeng1,2 JIA Yan1,2 QIU Zuyun1,2 SUN Xiaojie1,2 WANG Jianwei3 ZHANG Weiguang3 LI Shiliang1. Study on clinical anatomy of a new surgical method of needle-knife in the treatment of carpal tunnel syndrome. 中国医药导报, 2019, 16(9): 170-173.

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