| 摘要: |
| 目的 分析超声引导小针刀治疗成人屈指肌肌腱狭窄性腱鞘炎的有效性与安全性。方法 前瞻性抽取我院2017年11月至2018年11月符合条件的90例屈指肌肌腱狭窄性腱鞘炎成人患者,根据随机数字表法分为T1组、T2组、对照组,各30例,全部患者均接受小针刀治疗,对照组为传统盲视下操作,T1、T2组在超声引导下操作,前者为短轴超声引导,后者为长轴超声引导,治疗结束后随访6个月,评价各组治疗效果,记录患者随访期间并发症发生情况；治疗期间观察并对比3组治疗相关情况,包括治疗时间、治疗次数、恢复用时等；分别于各时点采用视觉模拟评分法(VAS)评价患者患指疼痛程度。结果 T1、T2组治愈率均高于对照组,差异有统计学意义(P＜0.05)；但其组间比较,差异无统计学意义(P＞0.05)；T1、T2组治疗时间、患指毛细血管充盈恢复时间、感觉恢复时间均短于对照组,治疗次数少于对照组,差异有统计学意义(P＜0.05)；T1、T2组治疗时间、治疗次数比较,差异无统计学意义(P＞0.05)；T2组毛细血管充盈恢复时间、感觉恢复时间均短于T1组,差异有统计学意义(P＜0.05)；治疗开始后各时点,3组VAS较治疗前均呈下降趋势,且T2组下降幅度最大,其次为T1组,对照组最小,3组组间、时点、组间.时点比较,差异有统计学意义(P＜0.05)；3组随访期间均未见并发症发生。结论 超声引导小针刀治疗成人屈指肌肌腱狭窄性腱鞘炎,治愈率高、治疗时间短、治疗次数少,尤其是在长轴、平面内超声引导下,治疗效果更佳,患者疼痛缓解明显,患指功能更好更快恢复,且无并发症发生,安全可靠。 |
| 关键词: 屈指肌肌腱狭窄性腱鞘炎 小针刀 短轴超声引导 长轴超声引导 |
| DOI： |
| 投稿时间：2019-02-22修订日期：2019-03-08 |
| 基金项目:（项目基金：四川省医学科研青年创新课题计划；项目名称：超声引导小针刀治 疗成人屈指肌肌腱狭窄性腱鞘炎的临床研究，课题编号：Q17068） |
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| Clinical study on ultrasound-guided small needle-knife in treatment of adult stenosing tenosynovitis of flexor digitorum |
| Tax cloud hua |
| (Department of Anesthesiology,Sichuan Orthopaedic Hospital) |
| Abstract: |
| Objective To analyze the effectiveness and safety of ultrasound-guided small needle-knife in treatment of adult stenosing tenosynovitis of flexor digitorum. Methods 90 adult patients with stenosing tenosynovitis of flexor digitorum in the hospital from November 2017 to November 2018 were prospectively selected. All the cases were divided into T1 group, T2 group and control group by random number table, with 30 cases in each group. All the patients underwent small needle-knife therapy, control group was given traditional blind operation, T1 group was given short-axis ultrasound-guided operation, while T2 group was given long-axis ultrasound-guided operation. During 6 months of follow-up after treatment, the curative effects of three groups were evaluated, and the incidence of complications was recorded; The treatment-related conditions of three groups during treatment were compared, including treatment time, number of treatment, recovery time; The pain degree of diseased finger was evaluated by visual analogue scale (VAS) at each time. Results The cure rate in T1 group and T2 group was higher than that in control group (P<0.05); But there was no statistical difference between T1 group and T2 group (P>0.05); The treatment time, recovery time of capillary filling, sensory recovery time in T1 group and T2 group were shorter than those in control group, the number of treatment in T1 group and T2 group was less than that in control group (P<0.05); There was no statistical difference in the treatment time and the number of treatment between the two groups (P>0.05); The recovery time of capillary filling, sensory recovery time in T2 group were shorter than those in T2 group (P<0.05); At each time after beginning of treatment, the VAS of three groups showed the decreasing trend, the decreasing range of T2 group was the largest, followed by T1 group, and control group was the smallest, the difference among the three groups was statistically significant (P<0.05); There were no complications in the three groups during follow-up. Conclusion Ultrasound-guided small needle-knife in treatment of adult stenosing tenosynovitis of flexor digitorum has high cure rate, short treatment time and less number of treatment. Long-axis ultrasound-guided small needle-knife has better effects, it can relieve pain, recover finger function and have no complications, which is safe and reliable. |
| Key words: stenosing tenosynovitis of flexor digitorum small needle-knife short-axis ultrasound-guided long-axis ultrasound-guided |
