TARIM İŞÇİLERİNDE ASEMPTOMATİK KARPAL TÜNEL SENDROMU

Dis hekimligi, kasaplik, marangozluk, muzisyenlik, ev kadinligi, kuaforluk gibi el ve el bileginin tekrarlayan zorlamali hareketleri ve titresimli el aletlerinin kullaniminin sik oldugu belirli meslek gruplarinda karpal tunel sendromu (KTS) riskinin arttigi gosterilmistir. Tarim iscilerinde de KTS riskinin arttigi belirtilmesine ragmen ulkemizde bu meslek grubunda yapilmis calisma bulunmamaktadir. Bu calismada bir grup tarim iscisinde KTS sikliginin arastirilmasi amaclanmistir. Ayni sahada calisan ve aydinlatilmis onam veren toplam 15 tarim iscisi (Kadin/Erkek:10/5) calismaya alindi. Tum hastalar dominant el, KTS semptomlari, sekonder KTS acisindan sorgulandi. Fizik ve norolojik muayeneleri ile Tinel ve Phallen testlerinin ardindan laboratuvar testleri (tam kan sayimi, eritrosit sedimentasyon hizi, aclik kan sekeri, tiroid fonksiyon testleri) yapildi. Ardindan sinir iletim calismasi her iki kola yapildi. Hastalar elektrofizyolojik olarak 4 grupta (normal, hafif, orta, agir KTS) olarak siniflandirildi. Hastalarin ortalama yaslari 28±14 idi. Hepsi erken yaslardan itibaren ciftcilik ile ugrasmaktaydi ve tumunde sag el dominansi mevcuttu. Hicbir hastada KTS semptomatolojisine ait yakinma, sekonder KTS nedenleri veya KTS nedeniyle cer-rahi oykusu ile anormal laboratuvar testleri saptanmadi. Tinel ve Phallen testi pozitiflikleri sirasiyla %72 ve %67 olarak bulundu. Sinir iletim calismasinda 11 (%73.3) hastada (K/E: 8/3) KTS saptandi. Mediyan sinir tuzaklanmasi tum hastalarda dominant elde bulundu. Toplam 21 (%70) el bileginde KTS vardi (1 elde agir, 15 elde orta, 5 elde hafif seklinde). Hastalarin hicbirinde KTS semptomu olmamasina ragmen, %73,3’unde KTS saptanmistir. Calisma grubunun kucuk olmasi nedeniyle ileri calismalara ihtiyac duyulmaktadir. Anahtar Kelimeler: Karpal tunel sendromu, tuzak noropati, meslek hastaliklari, EMG, tarim iscileri. Abstract Carpal tunnel syndrome (CTS) is frequently seen in jobs which need repetetive and vibrative movements of hands and wrists as carpenters, dentists, butchers, musicians. Although increase of CTS frequency is reported in farmers, no study was done in Turkish farmers. This study is aimed to investigate CTS frequency in a group of Turkish farmers. Fifteen (Female/Male: 10/5) farmers working in the same field were included into the study. All the subjects were questioned about dominant hand, CTS symptoms and secondary causes of CTS. Physical and neurological examinations and laboratory studies (hemogram, erytrtocyte sedi-mentation rate, blood glucose and thyroid func-tions) were performed. Phallen and Tinel tests were done. Nerve conduction studies (NCS) were applied to both of wrists and hands. Subjects were classified into 4 groups (normal, mild, mod-erate, severe) according to NCS. All of the subjects have been working from early ages and had right hand dominancy. Mean age was 28±14. None of them had CTS symp-toms, secondary causes of CTS and abnormal laboratory results. Tinel and Phalen tests were posi-tive in 72% and 67% of patients, respectively. CTS was found in 11 (F/M:8/3) (73,3%) of 15 subjects. All of CTS was found in dominant hand. Twenty one wrist had CTS (mild: 5, moderate: 15, severe: 1). Even though none of subjects had complaints of CTS symptoms, CTS was found in 73,3% of farmers. Since our study group is small, further studies are needed. Key words: Carpal tunnel syndrome, entrap-ment neuropathy, occupational disease, Elec-tromyography (EMG), farm workers.