低强度脉冲超声波对肌腱愈合的促进作用  

Effects of Low Intensity Pulsed Ultrasound on the Improvement of Flexor Tendon Healing

作　　者：刘沐青[1] 于志军[1] 秦永平[1] 徐闽娜[1] 王小勇[2] 李庆泰[3] 纪柳[1] 

机构地区：[1]清华大学玉泉医院,北京100049 [2]军事医学科学院,北京100850 [3]北京积水潭医院,北京100035

出　　处：《现代生物医学进展》2014年第10期1879-1882,共4页Progress in Modern Biomedicine

基　　金：首都医学发展科研基金项目(20093045)

摘　　要：目的:分析低强度脉冲超声波(low intensity pulsed ultrasound,LIPU)对Ⅱ区屈指肌腱愈合的促进作用,并探讨其减少肌腱粘连的临床效果。方法:选取2010年8月至2013年4月在我院接受II区屈指肌腱损伤修复术治疗的患者80例并随机分为两组。LIPU组(33例,共39指),该组患者均接受系统的低强度脉冲超声波进行治疗;对照组(34例,共41指),所有患者在治疗时放置超声探头,但不接通电源。在术后12周,采用视觉模拟评分法(visual analogue scale,VAS)评估患手疼痛程度;采用肌腱总主动活动度(total active motion,TAM)评定标准评价肌腱的功能状况;采用Lovett分级法评价患指屈指肌力。结果:两组术后无肌腱再断裂病例出现。术后12周时,LIPU组与对照组的VAS疼痛评分分别为(1.9±1.8)和(2.3±1.9)(t=0.996,P=0.337)。根据TAM系统评定标准,LIPU组与对照组的优良率分别为94.9%和70.7%,组间差异有统计学意义(X2=12.798,P=0.000),LIPU组显著高于对照组,两组患指屈指肌力恢复正常的发生率分别为100%和95.1%,组间差异无统计学意义(X2=1.951,P=0.162)。结论:LIPU具有促进II区屈指肌腱愈合,改善患指主动活动功能的效果,且不增加肌腱断裂的风险,但其促进肌腱愈合的机制尚需进一步实验研究证实。Objective： To analyze the effects of the low intensity pulsed ultrasound （LIPU） on the healing of Zone-II flexor tendon and to explore the reduction of the adhesion formation by LIPU. Methods： 67 patients （80 digits） with zone-II flexor tendon repairs in our hospital from August 2010 to April 2013 were assigned and randomly divided into the control group and LIPU group. Patients in the LIPU group （33 cases, 39 fingers ） were treated by LIPU, while the patients in the control group （34 cases, 41 fingers） were treated by the conventional method without the ultrasound therapy. All the patients were evaluated at 12 weeks after surgery by blinded observers. The fimction of the tendon was evaluated by the Strickland formula （total active motion） system, the pain scores of patients were evaluated by the visual analogue scale （VAS） and flexor strength was assessed. Results： The tendon re-rupture was not found after the surgery for all patients. At 12 weeks after surgery, VAS pain scores for LIPU group and the control group were （1.9±1.8） and （2.3± 1.9）, respectively （t = 0.996, P = 0.337）. According to TAM system, the excellent rates of LIPU group was 94.9% which was higher than that of the control group 70.7% （X^2=1.951, P=0.162）. The rate of the flexor strength to restore normal level in the LIPU group was 100% which was higher than that of the control group 95.1% （X^2=1.951, P=0.162）. Conclusions： LIPU therapy provides greater active finger motion than control group after zone-II flexor tendon repair without increasing the risk of tendon ruptaure. Further experiments are needed to reveal the mechanism of LIPU on tendon healing.

关 键 词：低强度脉冲超声波 屈指肌腱 愈合 术后粘连 

分 类 号：R687.2[医药卫生—骨科学] R454.3[医药卫生—外科学]