背景:关于腕管松解术(CTR)患者术后夹板的有效性存在争议。本研究旨在系统评估CTR手术中术后夹板固定效果的各种结果。
方法:多个数据库,包括PubMed,EMBASE,CINAHL,WebofScience,还有Cochrane,搜索与腕管综合征相关的术语。该荟萃分析共纳入了8项研究,涉及596例患者。评估了研究的质量,他们的偏倚风险是使用非随机研究方法学指数(MINORS)和Cochrane在随机对照试验中评估偏倚风险的协作工具计算的.数据包括视觉模拟量表(VAS),夹紧强度,握力,两点歧视,症状严重程度评分(SSS),提取功能状态量表(FSS)。
结果:我们的分析表明,基于VAS的夹板组和不夹板组之间没有显着差异,SSS,FSS,握力,夹紧强度,两点歧视。不同变量的标准化平均差(SMD)或加权平均差(WMD)和95%置信区间(CI)的计算值如下:VAS[SMD=0.004,95%CI(-0.214,0.222)],夹紧强度[WMD=1.061,95%CI(-0.559,2.681)],抓地强度[SMD=0.178,95%CI(-0.014,0.369)],SSS[WMD=0.026,95%CI(-0.191,0.242)],FSS[SMD=0.089,95%CI(-0.092,0.269)],和两点判别[SMD=0.557,95%CI(-0.140,1.253)]。
结论:我们的发现表明,在VAS方面,夹板组和不夹板组之间没有统计学上的显着差异,SSS,FSS,握力,夹紧强度,两点歧视。这些结果表明,没有大量证据支持CTR术后夹板的显着优势。
BACKGROUND: There is a controversy on the effectiveness of post-operating
splinting in patients with carpal tunnel release (CTR) surgery. This study aimed to systematically evaluate various outcomes regarding the effectiveness of post-operating
splinting in CTR surgery.
METHODS: Multiple databases, including PubMed, EMBASE, CINAHL, Web of Science, and Cochrane, were searched for terms related to carpal tunnel syndrome. A total of eight studies involving 596 patients were included in this meta-analysis. The quality of studies was evaluated, and their risk of bias was calculated using the methodological index for non-randomized studies (MINORS) and Cochrane\'s collaboration tool for assessing the risk of bias in randomized controlled trials. Data including the visual analogue scale (VAS), pinch strength, grip strength, two-point discrimination, symptom severity score (SSS), and functional status scale (FSS) were extracted.
RESULTS: Our analysis showed no significant differences between the splinted and non-splinted groups based on the VAS, SSS, FSS, grip strength, pinch strength, and two-point discrimination. The calculated values of the standardized mean difference (SMD) or the weighted mean difference (WMD) and a 95% confidence interval (CI) for different variables were as follows: VAS [SMD = 0.004, 95% CI (-0.214, 0.222)], pinch strength [WMD = 1.061, 95% CI (-0.559, 2.681)], grip strength [SMD = 0.178, 95% CI (-0.014, 0.369)], SSS [WMD = 0.026, 95% CI (- 0.191, 0.242)], FSS [SMD = 0.089, 95% CI (-0.092, 0.269)], and the two-point discrimination [SMD = 0.557, 95% CI (-0.140, 1.253)].
CONCLUSIONS: Our findings revealed no statistically significant differences between the splinted and non-splinted groups in terms of the VAS, SSS, FSS, grip strength, pinch strength, and two-point discrimination. These results indicate that there is no substantial evidence supporting a significant advantage of post-operative
splinting after CTR.