Study On Effects Of High Frequency Ultrasound And Electrophysiological Results And Their Correlation When The Carpal Tunnel Syndrome Treated In Different Sites

Objective: Patients with carpal tunnel syndrome,observe the changes ofmedian nerve cross-sectional area and the transverse carpal ligamentthickness in high frequency ultrasound, and the changes of median nervemotor latency and sensory conduction velocity in electrophysiologicalexamination after treatment in different sites with ultrasonic wave andultrashort wave therapy. To explore the best treatment site and thecorrelation between two examination methods.Methods: According to the inclusion criteria,70patients with87wristswere randomly divided into4groups, including3groups for the treatmentgroup, and1for the control group, the treatment group treated by ultrashortwave, ultrasonic and Mecobalamin treatment, the control group onlyreceived treatment of mecobalamin. Group A: take a treatment in entranceof the carpal tunnel (plane pisiform bone) and it’s proximal, treat group B inexit of the wrist (hook of hamate bone plane) and it’s distal, the treatment ofgroup C cover the entrance and exit plane. All of the4groups take the highfrequency ultrasound and electrophysiological examination before and after treatments.Results: After rehabilitation treatment for30days, in group A, the mediannerve cross-sectional area in carpal tunnel entrance level have decreased,the median nerve distal motor latency to the abductor pollicis brevis haveshortened, index finger to wrist median nerve sensory conduction velocityhave speeded, compared with the results before the treatment, thedifference was statistically significant (P <0.05). In group C, the medianCSA in carpal tunnel entrance level have reduced, the transverse carpalligament thickness in carpal tunnel export level have decreased, and themedian nerve DML have shortened, SCV have speeded, also compared withthe results before the treatment, the difference was statisticallysignificant (P <0.05). In group B, only the median nerve SCVslightly faster than that before treatment, the difference was statisticallysignificant (P <0.05). In the control group, the results of high frequencyultrasound and electrophysiological examination showed no significantchanges after the treatment. Analysis the correlation between the groupswhich have the meaningful changes of high frequency ultrasoundand electrophysiological examination: before the treatment, the mediannerve CSA in entrance level was negatively correlated with median nerveSCV (P <0.05),and the transverse carpal ligament thickness in carpal tunnelexport level was positively correlated with median nerve DML (P <0.05).In group C, after the treatment, the changes of median nerve SCV was positively correlated with the changes of median nerve CSA in carpal tunnelentrance level (P <0.05).Conclusions: In general, Curative effect of carpal tunnel syndrome is bestwhen the ultrashort wave and ultrasonic cure on both the carpal tunnelentrance and export plane. After the treatment, median nervecross-sectional area reduced more significantly, median nerve sensoryconduction velocity improved more obviously.