AĞIR KARPAL TÜNEL SENDROMU İÇİN RİSK FAKTÖRLERİNİN İNCELENMESİ - EV HANIMLIĞI BİR RİSK Mİ?

Öz

Karpal tünel sendromu (KTS) en sık görülen tuzak nöropatidir. Bu çalışmada ağır KTS için risk faktörleri incelenmiştir. Bu çalışma EMG Laboratuvarına başvuran ve Karpal Tünel Sendromu tanısı alan 227 hasta üstünde yapılmıştır. KTS tanı kriterleri olarak American Academy of Electrodiagnostic Medicine baz alınmıştır. Bütün hastalar bilateral median ve ulnar duyusal pik latans, amplitud ve ileti hızları açısından değerlendirilmiştir. Motor ileti çalışmasında ise bilateral median ve ulnar sinir motor latans, amplitud ve ileti hızları değerlendirildi. Hastalar elektrofizyolojik olarak 4 grupta sınıflandırılmıştır; Normal, Hafif, Orta, Ağır. Elektrofizyolojik sınıflandırma belirlenen risk faktörleri ile karşılaştırılmıştır. Hastaların yaş ortalaması 51.04±13.37’dir (min=18-max=83). Her iki elde de ağır KTS vakaları ev hanımlarında yüksektir. Ev hanımlığı sağ ve sol el ağır KTS riskini sırasıyla 2.74 ve 2.23 kat artırmıştır. Ayrıca ağır KTS riski obez olanlarda 5.10- 4.40 kat, lateral epikondilit varlığında 2.73-4.19 kat, medial epikondilit varlığında 4.39-4.93 kat arttığı bulunmuştur. Dominant elde ağır KTS gelişme riskinin de sol el için 6.88, sağ el için 1.15 kat arttığı bulunmuştur. Çoklu değişkenli analizlerde ise sol el için ağır KTS riskini obez olmanın 3.34 kat, kronik hastalık varlığının 2.62 kat, sol elin dominant olmasının 7.83 kat artırdığı, sağ el için ise ev hanımı olmanın 2.14 kat, obez olmanın 4.68 kat, medial epikondilit varlığının 6.40 kat artırdığı bulunmuştur. Ev hanımlığı, obezite, dominat elde KTS, medial ve lateral epikondilit varlığı ağır KTS için risk faktörü olarak bulunmuştur. KTS tanısı alan kişilerde belirtilen risk faktörlerine sahip olmaları durumunda ağır KTS açısından koruyucu yaklaşım önerilmektedir.

Anahtar Kelimeler

• karpal tünel sendromu
• kadın
• risk faktörü

RESEARCHING OF RISK FACTORS FOR SEVERE CARPAL TUNNEL SYNDROME - IS HOUSEWIFERY A RISK?

Öz

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. In this study, risk factors of severe CTS were examined. This study was conducted on 227 patients diagnosed with CTS in EMG laboratuary. The criteria of American Academy of Electrodiagnostic Medicine was used as the diagnosis for CTS. All patients were examined for bilateral median and ulnar motor and sensory peak latency, amplitude and conduction velocities. The patients were classified into 4 groups electrophysiologically; Normal, Light, Medium, Severe. Electrophysiological classification was compared with the identified risk factors. The mean age of the patients was 51.04±13.37 (min=18-max=83). Severe CTS cases in both hands were higher in housewives. Housewifery increased the risk of severe CTS in the right and left hand by 2.74 and 2.23 times, respectively. In addition, obesity increased the risk of severe CTS in the right and left hand by 5.10-4.40, presence of lateral epicondylitis was 2.73-4.19 and medial epicondylitis was 4.39-4.93, respectively. Hand dominancy was increased the risk of severe CTS by 6.88 times for the left hand and 1.15 times for the right hand. Otherwise in multivariate analyse of left hand results, obesity increase the risk of severe CTS by 3.34, left hand dominancy 7.83 times, chronic disease 2.62 times, and for the right hand being a housewife increases the risk by 2.14, obesity 4.68 times and medial epicondylitis 6.40 times. This study put forth that being a housewife, obesity, dominant hand, presence of lateral or medial epicondylitis are the risk factors of severe CTS.

Anahtar Kelimeler

• carpal tunnel syndrome
• woman
• risk factor

Kaynakça

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