低强度超声治疗桡骨远端骨折的临床研究  

Clinical low-intensity pulsed ultrasound in the treatment of distal radius fracture

作　　者：潘晓华 肖德明 徐忠世 林博文 谢伟平 黎伟凡 

机构地区：[1]暨南大学第二临床医学院(深圳市人民医院)骨科,深圳518010

出　　处：《中华物理医学与康复杂志》2006年第3期184-187,共4页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：深圳市科技计划项目立项课题(No.200404036)

摘　　要：目的观察我们自行研制的低强度超声仪用于桡骨远端骨折的治疗效果。方法选取90例闭合性桡骨远端A型骨折患者为研究对象,随机分为超声组44例(骨折手法复位、石膏外固定后给予超声治疗者)和对照组46例(单纯骨折手法复位、石膏外固定者)。超声组每天治疗1次、每次为20 min,超声平均强度为30 mW/cm2;所有患者均由同一组医生随访平均7．4(8-10)个月,观察两组骨折端复位及愈合过程、腕关节功能、并发症等相关指标并予以统计学分析。结果超声组与对照组相比,临床愈合时间(34．22± 5．34 vs 42．62±8．80 d,P<0．01)、骨性愈合时间(65．10±8．75 vs 80．53±9．25 d,P<0．01)、腕关节功能Di- enst分级评分(优:35 vs 28例、良:6 vs 7例、可:2 vs 3例、差:2 vs 8例,P<0．05)及Sudeck骨萎缩的发生率 (相对危险度下降82．6％)差异均具有统计学意义;通过解剖结构Aro等级评分未发现其对骨折复位后的结构稳定性造成不良影响。结论所研制的LIUS仪能够有效治疗桡骨远端A型骨折;有利于腕关节功能早期锻炼和完全恢复;LIUS能够预防及治疗Sudeck骨萎缩等骨折并发症。Objective To observe the clinical efficacy of a low-intensity poised ultrasound （LIUPS） apparatus developed by the authors for accelerating the healing of distal radius fractures. Methods Ninety patients with distal radius fracture （AO Muller type A） were randomly divided into a LIUPS group and a control group. All the patients in the LIUPS group were treated with pulsed ultrasound at an average intensity of 30 mW/cm^2 for 20 minutes once daily after manual reduction and cast immobilization, while those in the control group received only the manual reduction and cast immobilization. All the patients in both groups were followed up weekly by a group of orthopaedic surgeons for a period of 8 to 10 months （average 7.4 months） in terms of the clinical healing time, bone union time, wrist functional recovery and complications. Results There were significant differences between the two groups with regard to the time for clinical healing （ 34.22 ± 5.34 d vs 42.62 ± 8.80 d, P 〈 0.01 ） ,the time for bone union （65.10 ±8.75 vs 80.53 ± 9.25 d, P 〈 0.01 ）, wrist functional recovery as categorised by Dienst Classification （good：35 vs 28case, mild： 6 vs 7 cases, acceptable： 2 vs 3 cases and bad-2 vs 8 cases, P 〈0.05） and Sudeck atrophy occurrence （ RRR 82.6% ）. No anatomic instability of the reduced fractures nor any other side effects were observed during the LIUPS treatment. Conclusion The LIUPS apparatus can effectively accelerate the fracture-healing process, speed up functional recovery of the wrist,and prevent such complications as Sudeck atrophy caused by fracture.

关 键 词：低强度脉冲超声 桡骨远端骨折 愈合 SUDECK骨萎缩 治疗 

分 类 号：R454[医药卫生—治疗学]