{"id":115689,"date":"2018-03-11T10:44:21","date_gmt":"2018-03-11T10:44:21","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/sa%c2%adndrome-del-tunel-carpiano-idiopatico-correlacion-cla%c2%adnica-neurofisiologica-y-laboral-evolucion-de-los-parametros-neurofisiologicos-postratamiento-conservador-y-o-quirurgico\/"},"modified":"2018-03-11T10:44:21","modified_gmt":"2018-03-11T10:44:21","slug":"sa%c2%adndrome-del-tunel-carpiano-idiopatico-correlacion-cla%c2%adnica-neurofisiologica-y-laboral-evolucion-de-los-parametros-neurofisiologicos-postratamiento-conservador-y-o-quirurgico","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/medicina-interna\/sa%c2%adndrome-del-tunel-carpiano-idiopatico-correlacion-cla%c2%adnica-neurofisiologica-y-laboral-evolucion-de-los-parametros-neurofisiologicos-postratamiento-conservador-y-o-quirurgico\/","title":{"rendered":"S\u00edndrome del tunel carpiano idiop\u00e1tico: correlaci\u00f3n cl\u00ednica, neurofisiol\u00f3gica y laboral. evoluci\u00f3n de los par\u00e1metros neurofisiol\u00f3gicos postratamiento conservador y\/o quir\u00fargico."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Ana Belen Pinel Gonzalez <\/strong><\/h2>\n<p>Las opciones terap\u00e9uticas para los pacientes con s\u00edndrome del t\u00fanel carpiano se dividen en, conservadora o quir\u00fargica. Se plante\u00f3 evaluar la efectividad de  ambas, as\u00ed como la correlaci\u00f3n cl\u00ednico-el\u00e9ctrica posterior al tratamiento y analizar una posible asociaci\u00f3n entre factores epidemiol\u00f3gicos, semiol\u00f3gicos y neurofisiol\u00f3gicos, con una mayor gravedad y una evoluci\u00f3n cl\u00ednico-el\u00e9ctrica desfavorable post-tratamiento. Material y m\u00e9todos. Se realiz\u00f3 un estudio prospectivo y observacional de 50 pacientes consecutivos con cl\u00ednica de s\u00edndrome del t\u00fanel del carpo con confirmaci\u00f3n el\u00e9ctrica en la primera visita, con un total de 85 manos afectas. Se decidi\u00f3 tratamiento conservador en los casos leves o moderados con lmd menor que 4,5ms, e intervenci\u00f3n quir\u00fargica en los casos moderados con lmd mayor que 4,5ms o graves. Se realiz\u00f3 seguimiento a los tres, seis, doce y dieciocho meses, con reclasificaci\u00f3n de la gravedad y modificaci\u00f3n de tratamiento en funci\u00f3n de la evoluci\u00f3n. Resultados. Existe una mejor\u00eda cl\u00ednica y el\u00e9ctrica mayor y m\u00e1s precoz en el subgrupo quir\u00fargico, aunque estas diferencias no se mantuvieron al final del seguimiento. Un 41 por ciento de los casos tratados inicialmente con medidas conservadoras, ante la ausencia de mejor\u00eda precisaron descompresi\u00f3n quir\u00fargica durante el seguimiento. No hubo diferencias en la evoluci\u00f3n cl\u00ednico-el\u00e9ctrica con el grupo intervenido basalmente. Se asociaron con mayor gravedad el\u00e9ctrica los s\u00edntomas sensitivos negativos, la debilidad motora y los hallazgos exploratorios de hipoalgesia, paresia y amiotrofia. Ning\u00fan factor analizado condicion\u00f3 una evoluci\u00f3n cl\u00ednica menos favorable, tampoco la gravedad inicial, pero los pacientes asintom\u00e1ticos al final del seguimiento, fueron fundamentalmente los casos leves. S\u00f3lo la presencia de amiotrofia condicion\u00f3 una evoluci\u00f3n el\u00e9ctrica menos favorable. Ning\u00fan caso grave normaliz\u00f3 el estudio el\u00e9ctrico durante el seguimiento. Conclusiones. Ambas l\u00edneas de tratamiento fueron efectivas. El estudio neurofisiol\u00f3gico es un m\u00e9todo eficaz, como apoyo objetivo en el seguimiento evolutivo, por guardar buena relaci\u00f3n con las quejas cl\u00ednicas.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>S\u00edndrome del tunel carpiano idiop\u00e1tico: correlaci\u00f3n cl\u00ednica, neurofisiol\u00f3gica y laboral. evoluci\u00f3n de los par\u00e1metros neurofisiol\u00f3gicos postratamiento conservador y\/o quir\u00fargico.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 S\u00edndrome del tunel carpiano idiop\u00e1tico: correlaci\u00f3n cl\u00ednica, neurofisiol\u00f3gica y laboral. evoluci\u00f3n de los par\u00e1metros neurofisiol\u00f3gicos postratamiento conservador y\/o quir\u00fargico. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Ana Belen Pinel Gonzalez <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Complutense de Madrid<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 26\/05\/2014<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Eduardo Gutierrez Rivas<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Carlos Antonio P\u00e9rez de oteyza <\/li>\n<li>Juan  Carlos Mart\u00ednez castrillo (vocal)<\/li>\n<li>octavio Corral pazos de provens (vocal)<\/li>\n<li>margarita Rodrigo angulo (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Ana Belen Pinel Gonzalez Las opciones terap\u00e9uticas para los pacientes con s\u00edndrome del t\u00fanel carpiano se dividen [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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