Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Tıbbi Sekreterlerde Karpal Tünel Sendromuna Yatkınlık: Medyan Sinirin Ultrasonografi ile Değerlendirilmesi
A Predisposition to Carpal Tunnel Syndrome in the Medical Secretaries: Evaluation of the Median Nerve By Ultrasonography
Vefa ÇAKMAKa
aPamukkale Üniversitesi Tıp Fakültesi, Radyoloji ABD, Denizli, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2020;5(3):635-40
doi: 10.5336/healthsci.2020-73514
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, yoğun klavye ve bilgisayar kullanmakta olan tıbbi sekreterlerde, medyan sinir özelliklerinin araştırılması, deneyim ve günlük iş yükünün medyan sinire etkisinin belirlenmesidir. Gereç ve Yöntemler: Ekim 2019-Kasım 2019 tarihleri arasında bilgilendirilmiş onayı alınmış sağlıklı 28 kadın tıbbi sekreterin (26-39 yaş, ortanca 33 yaş, ortalama 32,82±4,03 yıl), her iki el bileği ultrasonografi ile prospektif olarak değerlendirilmiştir. Her iki el için aynı seansta medyan sinir ölçümleri, transvers planda karpal tünelin pisiform kemik düzeyinden yapılmıştır. Transvers planda medyan sinirin kesitsel alanı (MSKA), uzun ve kısa boyutları ölçülerek düzleşme oranı (flattening ratio) hesaplanmıştır. Tüm sekreterlerin, sekreter olarak çalışma tecrübesi, günlük aktif olarak çalışma süresi ve rapor sekreterlerinin günlük yazdığı rapor sayısı kaydedilmiştir. MSKA ve diğer ölçümlerin karşılaştırılması için 'paired t-testi' ve kategorik değişkenler için ki-kare testi kullanılmıştır. Bulgular: Rapor sekreterlerinde, karpal tünel sendromu prevalansı %25 olarak bulundu. Kayıt sekreterlerine göre rapor sekreterlerinin sağ el MSKA daha yüksek bulundu (p=0,018). Günlük yazılan rapor sayısının artışı ile MSKA artışı arasında her iki el için istatistiksel olarak anlam bulundu (sağ için p=0,009; sol için p=0,033). Mesleki tecrübe ve günlük aktif iş süresi için her iki elde istatistiksel olarak anlamlı farklılık saptanmamıştır. Sonuç: Kadın cinsiyete sahip, yoğun klavye ve bilgisayar kullanımı bulunan tıbbi sekreterlerde, karpal tünel sendromuna yatkınlık izlenmiştir.

Anahtar Kelimeler: Karpal tünel sendromu; ultrasonografi; medyan sinir
ABSTRACT
 Objective: The aim of this study is to investigate the median nerve characteristics in medical secretaries with intensive keyboard and computer use and to show the effect of experience and daily workload on the median nerve. Material and Methods: Between October 2019-November 2019, both wrists of 28 healthy female medical secretaries with informed consent (26-39 years, median 33 years, mean 32.82±4.03 years) were prospectively evaluated by ultrasonography. Median nerve measurements for both hands in the same session were performed from the pisiform bone level of the carpal tunnel in the transverse plan. Cross-sectional area of the median nerve (MNCA), long and short dimensions were measured in transverse plan and flattening ratio was calculated. All secretaries' experience of working as secretaries, daily active working time and the number of reports written by the report secretaries were recorded. Paired t test was used to compare MSKA and other measurements and chi-square test was used for categorical variables. Results: The prevalence of carpal tunnel syndrome was 25% in the report secretaries. The right-hand MSKA was found to be higher than the report secretaries (p=0.018). There was a statistically significant difference between the increase in the number of daily reports and the increase in MSKA for both hands (p=0.009 for right and p=0.033 for left). There was no statistically significant difference in both hands for professional experience and daily active working time. Conclusion: A predisposition to carpal tunnel syndrome was observed in female medical secretaries who used intense keyboard and computer.

Keywords: Carpal tunnel syndrome; ultrasonography; median nerve
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