改良開放式與密閉式腕隧道減壓手術效率與效果之比較

Abstract

本研究之目的在於比較作者服務的醫院中採用改良開放式與密閉式減壓術對於腕隧道症候群手術的效率與效果。研究的方法為收集自2004年2月至2005年5月止於作者服務醫院神經外科接受腕隧道減壓手術之83位（合計87次減壓手術）病患病歷資料(包括人口學資料與手術紀錄)，並針對病患接受手術之後的復原滿意度設計問卷，以電話訪談方式收集病患滿意度；所有資料以SAS統計軟體分析比較接受此兩種手術方式之病患在人口學、手術過程、術後滿意度方面的差異。結果顯示此兩組手術病患之人口學組成、術後滿意度均無顯著差異，但兩種手術方式在住院與否、麻醉方式及手術醫療成本方面具有顯著差異。本研究之結論認為：對於腕隧道症候群的治療，改良開放式減壓術較密閉式減壓術更具效率，而且具有與傳統開放式減壓術同樣之療效與安全性。

Background: Carpal tunnel syndrome (CTS) is one of the most common compression neuropathy problems in the upper extremity. The purpose of this study is to compare the efficiency and effectiveness and for modified open release and closed release techniques in a government owned hospital in Taiwan. Methods: Medical records of 83 cases who received 87 carpal tunnel syndrome release operations by neurosurgeon from Jan. 2004 to May 2005 were reviewed to collect their demographic and operation data. Than questionnaires about the post operation satisfaction were collected by phone interview. Data were analyzed by SAS statistic software to investigate the difference of demographic and operation procedures, post-operative satisfaction between the two operation groups. Results: There is no significant difference in demographic data and post operation satisfaction between the subjects of modified open and closed release procedures. However, there exist significant correlations in operation procedures with inpatient/outpatient surgery, with methods of anesthesia, and with average cost. Conclusions: Both release procedures are effective and safe for the patients. But the modified open release procedure is more efficient than closed release procedure in terms of health care resource consumption in treating CTS. This should enlighten hospital management on more effectively utilizing its limited health care resources.