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Miðtaugarþvingun í úlnliðsgöngum : athugun á 383 sjúklingum með einkenni í 557 höndum

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Authors
Marínó Pétur Hafstein
Brjánn Árni Bjarnason
Kristinn Tómasson
Issue Date
1994-09-01

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Other Titles
Carpal tunnel syndrome
Citation
Læknablaðið 1994, 80(7):300-9
Abstract
Analysed are the clinical data of 557 involved hands in 383 patients with carpal tunnel syndrome (CTS) diagnosed and treated in a private neurological practice in Reykjavik, Iceland over a seven year period. The subjects form a selected group as the patients are referred by medical practitioners or seek assistance on their own initiative. The study involved 241 females and 142 males. Age ranged from 14 to 91 years, mean 49 ± 16.5 years at the time of diagnosis. Both hands were involved in 45.5% of patients, judged clinically. Even though the mean age at diagnosis and duration of symptoms were similar to other studies patients in younger age groups were more common in this study (figure 1). Occupation was known for 376 patients. The occupational classes for the patients are shown in table IV compared to a recent national survey on occupational classification in Iceland. Of 239 females 193 (80.6%) were housewives and of those 152 (78.7%) were also employed. Of the employed patients 82.3% males and 48.8% females were in occupational classes involving manual work compared to 49.5% males and 24.3% females in the control group. The dominant hand was the only hand involved or with worse symptoms in 67.2% of patients (table I). Is CTS an occupational disease? Definite conclusions can not be drawn from these results. Manual workers might seek medical attention more frequently for their symptoms. Symptoms and signs in the 577 hands are shown in table II. Further study on the incidence of CTS in Iceland and it's relationship to the patient's occupation is needed.
Tilgangur rannsóknarinnar er að skilgreina kvartanir og einkenni fólks með miðtaugarþvingun í úlnliðsgöngum (carpal tunnel syndrome: CTS), sjúkdómsgreint og meðhöndlað á læknastofu í Reykjavik. Um er að ræða 383 einstaklinga með einkenni í 557 höndum. Fólk á aldrinum 20-39 ára leitaði sér aðstoðar fyrr en aðrir í þessari rannsókn og samanborið við aðrar rannsóknir er þessi aldurshópur fjölmennari hjá okkur. Kvillinn fannst í báðum höndum hjá 45,5% sjúklinga. Ríkjandi hönd var oftar með miðtaugarþvingun í úlnliðsgöngum, eða með verri einkenni, og taugarfergið greindist oftar hjá einstaklingum í starfsstéttum þar sem álag á hendur er mikiö. Kvartað var um dofa og/eða pínudofa í 97,5% handa og var hann í öllum fingrum í 69% tilvika. Skynskoðun var óeðlileg í 63% handa og af þeim í sérkennandi miðtaugarskyndreifingu í aðeins 44% tilvika. Verkur var í 72% handa og af þeim í yfir 50% tilvika einnig utan handarsvæðis, það er að segja „nærverkur" (proximal pain). Áttatíu og átta present sjúklinga vöknuðu að næturlagi eða snemma morguns með verri einkenni og margir höfðu þau aðeins þá. Erfitt er að lýsa dæmigerðri staðsetningu einkenna hjá sjúklingum með miðtaugarfergi í úlnliðsgöngum.
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