Primerjava učinkov operativnega in konzervativnega zdravljenja pri pacientih s sindromom zapestnega prehoda - pregled literature : diplomsko delo

Tučen, Taja (author), Hlebš, Sonja (mentor), Kacin, Alan (reviewer)

Uvod: Sindrom zapestnega prehoda je najpogostejša utesnitvena periferna nevropatija zgornjih okončin, ki jo povzroči kompresija ali trakcija medianega živca, ki poteka skozi zapestni prehod in prizadene približno 3,8% splošne odrasle populacije. Lahko je posledica povečanega pritiska v zapestnem prehodu, motnje mikrocirkulacije v medianem živcu, kompresije živčnega vezivnega tkiva, ki obdaja mediani živec in hipertrofije sinovialne ovojnice tetiv fleksornih mišic. Najbolj pogosti simptomi so bolečina, otrplost, mravljinčenje in pekoč občutek na palcu kazalcu, sredincu in prstancu. Zdravljenje sindroma zapestnega prehoda delimo na konzervativno in operativno. Konzervativno zdravljenje je možno z opornico, injekcijami kortikosteroidov, oralnimi kortikosteroidi, nesteroidnimi protivnetnimi zdravili, vitaminom B6, diuretiki, ultrazvokom in fizioterapijo. Izbira oblike zdravljenja temelji na resnosti sindromov. Namen: Namen diplomskega dela je na podlagi pregleda literature primerjati učinke operativnega in konzervativnega zdravljenja sindroma zapestnega prehoda. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo. Literaturo smo poiskali v spletnih podatkovnih zbirkah PubMed in Cochrane Library ter z iskanjem v referencah objavljenih pregledov literature. Vključili smo raziskave objavljene po letu 2002. Izbranih je bilo osem člankov v angleškem jeziku, v katerih so primerjali učinke operativnega in konzervativnega zdravljenja pacientov s sindromom zapestnega prehoda. Rezultati: Za ocenjevanje učinkovitosti zdravljenja so bile uporabljene različne ocenjevalne lestvice in merilna orodja. Rezultati analiziranih raziskav nakazujejo večjo učinkovitost operacije po šestih in dvanajstih mesecih za zmanjševanje resnosti simptomov, izboljšanje funkcijskega statusa in elektro-fizioloških meritev. Razprava in zaključek: Obe obliki zdravljenja prinašata koristi za zdravljenje sindroma zapestnega prehoda. Konzervativno zdravljenje se je kratkoročno izkazalo za učinkovitejše, medtem ko je operativno zdravljenje dolgoročno tako klinično kot tudi elektro-fiziološko bolj učinkovito. Potrebne bi bile dodatne študije, ki bi proučevale dolgoročne učinke zdravljenja.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, sindrom zapestnega prehoda, operativno in ne-operativno zdravljenje, operativno in konzervativno zdravljenje, operacija, konzervativno zdravljenje
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [T. Tučen]
• Year: 2021
• Number of pages: 33 str., [2] str. pril.
• PID: 20.500.12556/RUL-129582
• UDC: 615.8
• COBISS.SI-ID: 75479811
• Publication date in RUL: 05.09.2021

Secondary language

• Language: English
• Title: Comparison of the effects of surgical and conservative treatment in patients with carpal tunnel syndrome - literature review : diploma work

Abstract

Introduction: Carpal tunnel syndrome is the most common entrapment peripheral neuropathy of the upper extremities caused by compression or traction of the median nerve, which is passing through the carpal tunnel. Carpal tunnel syndrome is affecting approximately 3,8% of the general adult population. It may be due to increased pressure un the carpal tunnel, microcirculation disorders in the median nerve, compression of the nerve connective tissue surrounding the median nerve and hypertrophy of the synovial sheath of the flexor muscles tendons. The most common symptoms are pain, numbness, tingling and burning on the thumb, middle and ring finger. The treatment of carpal tunnel syndrome is divided into conservative and operative. Conservative treatment is possible with splint, steroid injections, oral corticosteroids, nonsteroidal anti-inflammatory drugs, vitamin B6, diuretics, ultrasound and physiotherapy. The choice of treatment is based on the severity of the symptoms. Purpose: The purpose of this diploma work was to compare the effects of operative and conservative treatment of carpal tunnel syndrome with a systematic literature review. Methods: In this diploma work we used a descriptive method. Literature was searched in the online databases PubMed and Cochrane Library and by searching the references of published literature reviews. We included studies published after 2002. We selected eight articles in English which compared operative and conservative treatment in patients with carpal tunnel syndrome. Results: Various assessment scales and measurement tools were used to assess the effectiveness of the treatment. The results of the analysed studies indicate a greater efficiency of the operation after six and twelve months in the severity of symptoms, functional status and electro-physiological measurements. Discussion and conclusion: Both forms of treatment bring benefits in the treatment of carpal tunnel syndrome. Conservative treatment has been shown to be more effective in the short term, while operative treatment has been more effective in the long term, both clinically and electro-physiologically. Additional studies are needed to examine the long-term effects of treatment.

• Keywords: diploma theses, physiotherapy, carpal tunnel syndrome, surgical versus non-operative treatment, surgery versus conservative treatment, surgery, conservative treatment