Karpal tünel sendromlu hastalarda rutin hematolojik ve inflamasyon parametrelerinin cerrahi tedavi sonuçları ile ilişkisi

Year 2020, , 1227 - 1230, 01.12.2020

Muzaffer Güneş

https://doi.org/10.28982/josam.827520

Abstract

Amaç: Nötrofil/lenfosit oranı (NLO), nötrofil/eozinofil oranı (NEO) ve C-reaktif protein/albumin oranı (CAO) sistemik inflamasyonu yansıtır. Ancak, bunların karpal tünel sendromu (KTS) cerrahi tedavisi ile ilişkisi çalışılmamıştır. Bu çalışmada, nörofizyolojik olarak orta KTS’li hastalarda sistemik inflamasyon parametreleri ile KTS cerrahi tedavi sonuçları arasındaki ilişki araştırıldı.
Yöntemler: Bu çalışma, orta KTS nedeniyle cerrahi tedavi yapılmış hastalar üzerinde retrospektif olarak yapıldı. Cerrahi sonrası sonuçlar, ameliyattan yaklaşık 6 ay sonra yapılmış bir sinir iletim çalışması (SİÇ) ile değerlendirildi. Cerrahi sonrası SİÇ’e göre hastalar üç gruba ayrıldı: SİÇ ile KTS saptanmayan hastalar cerrahi tedaviden “tam faydalanan grup”, hafif KTS saptanan hastalar “kısmi faydalanan grup” ve orta veya şiddetli KTS saptanan hastalar ise cerrahi tedaviden “hiç faydalanmayan grup” olarak tanımlandı.
Bulgular: Çalışmaya, 41 orta KTS’li hasta alındı. Gruplar arasında medyan CAO, beyaz kan hücresi (WBC), nötrofil, NEO ve C-reaktif protein (CRP) düzeyleri açısından anlamlı fark gözlenmiştir (sırasıyla P<0,001; P=0,012; P=0,014; P=0,005 ve P=0,001). Ayrıca, cerrahi sonrası KTS şiddeti ile CAO (rho: 0,633; P<0,001) ve CRP (rho: 0,603; P<0,001) arasında istatistiksel olarak anlamlı ve güçlü pozitif korelasyon vardı.
Sonuç: Bu çalışmada, daha yüksek CAO düzeyine sahip KTS hastalarının cerrahi tedaviden daha az fayda sağladığı bulunmuştur.

Keywords

C-reaktif protein/albumin oranı, Cerrahi tedavi, Karpal tünel sendromu, Nötrofil/eozinofil oranı, Sistemik inflamasyon

Association of routine hematological and inflammation parameters with surgical treatment results in patients with carpal tunnel syndrome

Abstract

Aim: Neutrophil/lymphocyte ratio, neutrophil/eosinophil ratio (NER), and C-reactive protein-to-albumin ratio (CAR) reflect systemic inflammation. However, their relationship with the surgical treatment of carpal tunnel syndrome (CTS) has not been studied. In the present research, the association between systemic inflammation parameters and CTS surgical treatment results was investigated in patients with neurophysiologically moderate CTS.
Methods: The present study was conducted retrospectively on patients who underwent surgical treatment owing to moderate CTS. The postoperative results were evaluated by a nerve conduction study (NCS) performed approximately 6 months after the surgery. Patients were divided into three groups based on the postoperative NCS: Patients who did not have CTS according to NCS were defined as “the group fully benefiting” from surgical treatment, patients with mild CTS were included in “the group partially benefiting,” from surgical treatment, and patients with moderate or severe CTS were included in “the group with no benefit.”
Results: Forty-one patients with moderate CTS were included in the study. There was a significant difference between the groups in terms of median CAR, white blood cell, neutrophil, NER, and C-reactive protein (CRP) levels (P<0.001, P=0.012, P=0.014, P=0.005 and P=0.001, respectively). There was also a statistically significant and strong positive correlation among postoperative CTS severity, CAR (rho: 0.633, P<0.001) and CRP (rho: 0.603, P<0.001).
Conclusion: In the current study, it was found that CTS patients with higher CAR levels achieved less benefit from the surgical treatment.

Keywords

C-reactive protein/albumin ratio, Surgical treatment, Carpal tunnel syndrome, Neutrophil/eosinophil ratio, Systemic inflammation

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