neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2021-23-3-39-47neurosurgery-1075Research ArticleОРИГИНАЛЬНАЯ РАБОТАORIGINAL REPORTОпыт применения противоспаечного геля в хирургическом лечении компрессионной невропатии срединного нерва на уровне запястного каналаThe experience of using anti-adhesion gel in the surgery for carpal tunnel syndromehttps://orcid.org/0000-0002-1755-1752НикитинА. С.NikitinA. S.

Андрей Сергеевич Никитин 

127473 Москва, ул. Делегатская, 20, стр. 1

Andrey S. Nikitin

Bld. 1, 20 Delegatskaya St., Moscow 127473

zateya@bk.ruhttps://orcid.org/0000-0003-4937-0400АлейниковаИ. Б.AleynikovaI. B.

129090 Москва, Большая Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090

ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава РоссииРоссияA.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of RussiaRussian FederationГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского Департамента здравоохранения г. Москвы»РоссияN.V. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian Federation2021241020212333947Copyright © Никитин А.С., Алейникова И.Б., 20212021Никитин А.С., Алейникова И.Б.Nikitin A.S., Aleynikova I.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1075Введение

Введение. Одна из причин неудовлетворительных исходов операций по декомпрессии запястного канала – образование рубцов с повторным поражением срединного нерва. В связи с этим продолжается поиск средств и методов, позволяющих снизить риск данного осложнения.

Цель исследования – оценить эффективность противоспаечного геля в профилактике рубцовых осложнений операций по декомпрессии срединного нерва.

Материалы и методы

Материалы и методы. Проведено проспективное исследование с участием 55 пациентов с синдромом запястного канала. Всем больным выполнена открытая декомпрессия запястного канала. Пациентам основной группы (n = 25) перед зашиванием раны на нерв наносили противоспаечный гель на основе карбоксиметилцеллюлозы, пациентам контрольной группы (n = 30) противоспаечный гель не наносили. До операции осуществляли клинико‑неврологический осмотр с оценкой выраженности симптомов компрессии запястного канала по бостонскому опроснику (Boston Carpal Tunnel Questionnaire, BCTQ), включающему 2 шкалы: шкалу тяжести симптомов (symptom severity scale, SSS) и шкалу функционального статуса (functional status scale, FSS). Повторную оценку по бостонскому опроснику проводили через 2,5 года после операции.

Результаты

Результаты. У пациентов основной группы тяжесть симптомов по BCTQ уменьшилась на 59,5 %, а функциональный статус улучшился на 55,1 %, у пациентов контрольной группы – соответственно на 48,3 и 47,6 %. Клинические рецидивы заболевания зарегистрированы у 8 и 20 % пациентов основной и контрольной групп соответственно.

Заключение

Заключение. Интраоперационное использование противоспаечного геля на основе карбоксиметилцеллюлозы позволяет снизить частоту рецидивов синдрома запястного канала после хирургической декомпрессии.

The study objective is to evaluate the effectiveness of anti‑adhesion gel by using in carpal tunnel syndrome surgery.

Materials and methods

Materials and methods. A prospective study was carried out among 55 patients with carpal tunnel syndrome. All patients were underwent open decompression of the carpal tunnel. Patients of study group (n = 25) got an carboxymethylcellu‑ lose anti‑adhesion gel, which was applied to the nerve before suturing the wound. Patients from control group (n = 30) were underwent surgery without using an anti‑adhesive gel. Before surgery, all patients underwent a clinical neurological examination with an assessment of symptoms according to the Boston Carpal Tunnel Questionnaire, which includes 2 scales: the scale and the functional status scale. The Boston Carpal Tunnel Questionnaire was reevaluated 2.5 years after surgery.

Results

Results. In study group the mean symptom severity decreased by 59.5 %, functional status improved by 55.1 %, in control group these indicators were 48.3 and 47.6 %. Clinical relapse of the disease was noted in 8 % of patients of study group and in 20 % of patients of control group.

Conclusion

Conclusion. Intraoperative using of an anti‑adhesion gel allows to reduce the frequency of recurrence of carpal tunnel syndrome after surgical decompression.

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The authors declare that there are no conflicts of interest present.