超声引导下小针刀治疗屈指肌腱狭窄性腱鞘炎疗效观察

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英文篇名：Ultrasound-guided needle-knife for trigger finger 作者：张文兵 ; 姚东文 ; 吴韦贤 英文作者：ZHANG Wen-bing;YAO Dong-wen;WU Wei-xian;Department of Pain Management,People's Hospital Affiliated to Fujian University of TCM;Department of Ultrasound,People's Hospital Affiliated to Fujian University of TCM; 关键词：扳机指 ; 指屈肌腱狭窄性腱鞘炎 ; 阿是穴 ; 三维立体定位 ; 超声引导 ; 针刀 英文关键词：trigger finger;;stenosing tenosynovitis of flexor tendon;;ashi point;;three-dimensional positioning;;ultrasonic guidance;;needle-knife 中文刊名：ZGZE 英文刊名：Chinese Acupuncture & Moxibustion 机构：福建中医药大学附属人民医院疼痛科;福建中医药大学附属人民医院超声科; 出版日期：2019-08-07 16:13 出版单位：中国针灸 年：2019 期：v.39;No.371 语种：中文; 页：ZGZE201908021 页数：4 CN：08 ISSN：11-2024/R 分类号：73-76

摘要

目的:探讨超声引导下精准三维立体定位阿是穴行小针刀靶点松解术治疗屈指肌腱狭窄性腱鞘炎(扳机指)的疗效。方法:将74例患者随机分为观察组与对照组,每组37例。观察组采用超声引导下腱鞘内注药术并针刀松解术治疗,对照组单纯采用超声引导下腱鞘内注药术治疗。观察两组患者治疗前、治疗后即时、治疗后1个月、治疗后3个月的自拟扳机指九分评定表评分变化,并评定两组疗效。结果:治疗后即时、1个月、3个月观察组扳机指九分评定表评分较治疗前均降低(均P<0.01),治疗后各个观察时点观察组评分均低于对照组(均P<0.01)。观察组治疗后即时优良率为100.0%(37/37),优于对照组的8.1%(3/37,P<0.05);治疗后1个月、治疗后3个月观察组痊愈率分别为100.0%(37/37)、97.3%(36/37),优于对照组的13.5%(5/37)、10.8%(4/37,P<0.05)。结论:阿是穴三维立体定位下小针刀治疗扳机指可明显改善症状,即时及远期疗效较好。
        Objective To explore the efficacy of ultrasound-guided needle-knife with precise three-dimensional stereotactic localization of ashi points for stenosing tenosynovitis of flexor tendon(trigger finger). Methods A total of 74 patients were randomly divided into an observation group and a control group, 37 cases in each group. The patients in the observation group were treated with ultrasound-guided intrathecal injection and releasing method of needle-knife, while the patients in the control group were treated with ultrasound-guided intrathecal injection. The self-made 9-score scale of trigger finger was recorded before treatment, immediately after treatment, 1 month and 3 months after treatment; the curative effect of the two groups was evaluated. Results The results of self-made 9-score scale in the observation group immediately after treatment, 1 month and 3 months after treatment were lower than that before treatment(all P<0.01); the scores in the observation group were lower than those in the control group at each time point after treatment(all P<0.01). The excellent and good rate immediately after treatment was 100.0%(37/37) in the observation group, which was superior to 8.1%(3/37) in the control group(P<0.05); the cured rates in the observation group were 100.0%(37/37) 1 month after treatment and 97.3%(36/37) 3 months after treatment, which were superior to 13.5%(5/37) and 10.8%(4/37) in the control group, respectively(P<0.05). Conclusion The needle-knife with three-dimensional stereotaxic location of ashi point could significantly improve the symptoms of trigger finger, with superior immediate and long-term efficacy.

引文

[1]张继伟,江苏闽,吴海波,等.针刀治疗屈指肌腱狭窄性腱鞘炎系统评价[J].中国中医药信息杂志, 2016, 23(7):46-50.
    [2]中华人民共和国中医药行业标准.中医病证诊断疗效标准[M].北京:中国医药科技出版社, 2012:198-199.
    [3]欧阳洁,李义凯,岳永斌,等.针刀治疗扳机指操作方法对手指掌侧面局部解剖结构损伤情况的研究[J]. 2010, 25(6):523-526.
    [4]欧阳洁.针刀治疗狭窄性腱鞘炎的解剖学安全性研究[D].广州:南方医科大学, 2010.
    [5]杨义靖,罗开旭.盲切法治疗扳机指近况[J].中国骨伤, 2001,14(5):308-309.
    [6]英奇,段永刚,李奎,等.小针刀治疗腱鞘炎并发症临床分析[J].河北北方学院学报(医学版), 2007, 24(3):67.
    [7]许文湘.小针刀治疗腱鞘炎并发症及处理[J].实用手外科杂志,2003, 17(3):186.
    [8]丁英奇,段永刚,李耀华,等.小针刀治疗腱鞘炎并发症临床分析[J].河北北方学院学报(医学版), 2007, 24(3):67-68.
    [9] Hansen RL, S?ndergaard M, Lange J.Open surgery versus ultrasound-guided corticosteroid injection for trigger finger:a randomized controlled trial with 1-year follow-up[J]. J Hand Surg Am, 2017, 42(5):359-366.
    [10]尹莉,郭瑞君.高频超声在扳机指的应用现状与进展[J].中华医学超声杂志(电子版), 2016, 13(11):875-880.
    [11]王锋,张雪芹.腱鞘内注射与小针刀治疗屈指肌腱腱鞘炎的临床观察[J].宁夏医科大学学报, 2010, 32(1):110-112.