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Re: Невропатия срединного нерва в результате сдавления сухожильным ганглием
Мельников В.С. 21 Март 2012, 03:52
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Читать такие работы одно удовольствие. Но мне кажется в понятие conservative interventions включены не только инъекции стероидных препаратов, но и как минимум такие варианты как activity modification and splinting. Так что не гормоном единым...
Вот еще несколько выдержек из трудов уважаемых людей в уважаемых изданиях:
«A study examining injections [12] found long-term relief of symptoms (1 year) in only 24% of subjects. An additional 27% responded initially but then had a reoccurrence of symptoms within 1 year. Various other studies have reported success rates from 13% to 92% utilizing injections alone or combined with splinting [10,14,16]. Success rates were defined as lasting improvement in symptoms 11–18 months in duration. Response to an injection can also correlate
and predict the response to surgical release» - 280 A.L. Osterman et al / Hand Clin 18 (2002) 279–289
«Patients with very mild and intermittent symptoms of CTS should have a trial of сonservative treatment. Basic to this is extension wrist splinting for nocturnal distress. Of course, any predisposing general medical condition such as hypothyroidism should be corrected. The value of large doses of vitamin B6
(pyridoxine) is unproven. It appears possibly to provide some transient reduction in symptoms, but not to contribute to a cure. The result of systemic antiinflammatory
medications, diuretics, and so on, in general has not been of lasting value. Сortisone injections into the carpal tunnel should be given in special circumstances only….» - Beasley’s Surgery of the Hand 2003
Ну и конечно не такой свежий (как Ваш) источник "вдохновения"... статья называется Corticosteroid Injections: Their Use and Abuse опубликована
Vol 2, No 3, May/June 1994 Journal of the American Academy of Orthopedic Surgeons Paul D. Fadale, MD, and Michael E. Wiggins, MD «In a prospective study in which 41 patients with carpal tunnel syndrome (50 hands) were treated with a single corticosteroid injection and 3 weeks of splinting, only 22% of hands became completely symptom free…… As a general rule, multiple injections should be avoided, but there are exceptions, such as unicameral bone cysts, rheumatoid arthritis, and selected cases of osteoarthritis.»
Как то так.
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