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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Comprehensive Evaluation of Effect of Low Dose Local Steroid Injection in Carpal Tunnel Syndrome
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Comprehensive Evaluation of Effect of Low Dose Local Steroid Injection in Carpal Tunnel Syndrome

机译：低剂量局部类固醇注射症综合评价腕管综合征

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Carpal Tunnel Syndrome (CTS) is one of the most common entrapment neuropathy with significant affection of hand function. Diagnosis is based on clinical, electrophysiological findings and ultrasonographic findings. Treatment may be nonsurgical or surgical. Of the nonsurgical methods, local glucocorticoid injection has yielded promising results in mild to moderate CTS. Use of different doses of steroid for CTS ranging from 12 mg to 40 mg with comparable results has been reported in the literature. To the best of our knowledge, efficacy of low dose steroid injection has not been evaluated in a comprehensive manner.Aim: To assess the efficacy of a low dose local steroid injection in CTS patients utilising clinical, electrophysiological and ultrasonographic parameters.Materials and Methods: Fifty five diagnosed patients of mild and moderate CTS, on the basis of electrophysiologic findings, were recruited for the study. Clinical evaluation was done in terms of grip strength and pain status. For baseline electrophysiological evaluation, nerve conduction studies were performed. This included Sensory Nerve Action Potentials (SNAPs), Sensory Distal Latency (SDL), Motor Distal Latency (MDL) and sensory and motor Conduction Velocity (CV) of median nerve as assessment parameters. Cross Sectional Area (CSA) of median nerve and bowing of flexor retinaculum was assessed using ultrasonography. Single dose of 20 mg methylprednisolone acetate was injected into the carpal tunnel under all aseptic precautions. Pain status was assessed at one week after the procedure. Overall, efficacy of the intervention was assessed using all the assessment parameters at one and three months after intervention. Statistical analysis was done using SPSS version 17 and p-value of <0.05 was considered as statistically significant.Results: 44 patients completed three months follow-up period. Most of the parameters assessed showed improvement at one month and three months after the intervention. At one month, grip strength, pain, SNAP, MDL, sensory CV and CSA of median nerve were found to be significantly improved. At three months follow-up, in addition to the further improvement in these parameters, SDL also showed significant improvement in comparison to baseline. However, motor nerve CV showed no significant improvement during the study period.Conclusion: Low dose local steroid injection is an effective intervention for treating CTS subjects. It provides rapid pain relief and improvement in objective parameters which persists till the end of three months.
机译：Carpal隧道综合征（CTS）是最常见的血栓病之一，具有重要的手功能。诊断是基于临床，电生理结果和超声波调查结果。治疗可能是非局部或外科手术的。在非技术方法中，局部糖皮质激素注射液产生了高级至中等CTS的有希望的结果。在文献中报道了使用不同剂量的类固醇，用于12mg至40毫克，在文献中报告了可比的结果。据我们所知，低剂量类固醇注射的疗效尚未以综合方式评估。目的：评估利用临床，电生理和超声参数的CTS患者低剂量局部类固醇注射的疗效。< B>材料和方法：在电生理调查结果的基础上，招募了五十五名患者轻度和中度CTS患者。临床评估是在握持强度和疼痛状态方面进行的。对于基线电生理学评估，进行神经传导研究。这包括感觉神经动作电位（SNAPS），感觉远端等待时间（SDL），电机远端（MDL）和中位神经的感觉和电机传导速度（CV）作为评估参数。使用超声检查评估屈肌和弯曲的中位神经和弯曲的横截面积（CSA）。根据所有无菌预防措施将单剂量为20mg甲基丙酮酮乙酸盐注入腕管中。在程序后一周评估疼痛状态。总体而言，使用介入后的一年和三个月的所有评估参数评估干预的疗效。使用SPSS版本17进行统计分析，并且P值为<0.05被认为是统计学意义的。结果：44名患者完成了三个月的随访期。评估的大多数参数在干预后一个月和三个月内显示出改善。在一个月内，发现握持强度，疼痛，乳房，MDL，感官CV和中位神经的CSA显着改善。在三个月后，除了进一步改善这些参数外，SDL还与基线相比显示出显着的改善。然而，在研究期间，运动神经CV没有显着改善。结论：低剂量局部类固醇注射是治疗CTS受试者的有效干预。它提供快速的疼痛缓解和改善目标参数，持续到三个月结束。

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