高频超声用于手部肌腱断裂诊断、定位引导治疗和术后功能康复评估的临床研究  

Application of high frequency ultrasound in diagnosis of hand tendon rupture, positioning guide for treatment and postoperative rehabilitation evaluation

作　　者：李士杰 张天元 叶旭红 张梅美 潘善锋 单雪林 蒋春景[2] 蒋良福[3] 

机构地区：[1]浙江省东阳市横店集团医院,浙江东阳322118 [2]浙江省金华市中心医院,浙江金华322000 [3]温州医科大学第二附属医院,浙江温州325027

出　　处：《中国现代医生》2015年第5期82-85,共4页China Modern Doctor

基　　金：浙江省金华市科技研究计划重点项目(2013-3-002;2013-3-115);浙江省自然科学基金资助项目(Y2100253)

摘　　要：目的分析高频超声用于术前手部肌腱断裂诊断、断端定位引导手术和术后功能康复评估的临床价值。方法87例手部疑似肌腱断裂患者进行超声诊断、术前断端定位和术后功能评估以分析其对手部肌腱断裂治疗的临床价值。结果 87例疑似手部肌腱断裂患者经高频超声确诊为肌腱不完全断裂患者11例,肌腱断裂患者76例。76例患者指屈肌腱断裂47例60条肌腱,其中Ⅱ区22例28腱,Ⅲ区14例18腱,Ⅳ区11例14腱;指伸肌腱断裂29例40腱,其中Ⅱ区12例18腱,Ⅲ区10例14腱,Ⅳ区7例8腱。上述结果与术中探查结果完全一致。术后高频超声初筛出53例患者属于肌腱腱性连接,10例患者出现重度瘢痕连接,13例患者出现轻度瘢痕连接;术后采用高频超声持续观察肌腱康复情况,并及时选用恰当的治疗手段,实验组TAM疗效评估结果明显优于对照组。结论高频超声不但可准确诊断手部肌腱断裂和术后肌腱腱性连接和瘢痕连接,确定肌腱断端位置并可对瘢痕连接进行分级,通过持续的高频超声监测指导术后后期选择合适的治疗手段可显著提高肌腱断裂患者的手部功能康复。Objective To explore application of high frequency ultrasound in preoperative hand rendon rupture diagnosis, positioning guide treatment and postoperative rehabilitation evaluation. Methods Preoperative diagnosis of hand rendon rupture, positioning guide treatment and postoperative rehabilitation evaluation were conducted in 87 suspected patients using high frequency ultrasound. Results The respective number of diagnosed tendon rupture, incomplete tendon rupture patients were 76 and 11. 47 patients（60 tendons） were flexor tendon rupture, and the number of zone Ⅱ,Ⅲ and Ⅳ were 22（28 tendons）, 14（18 tendons） and 11（14 tendons）, respectively. 29 patients with 40 tendons were diagnosed as extensor tendon rupture, and the number of zone Ⅱ, Ⅲ and Ⅳ were 12（18 tendons）, 10（14 tendons）and 7（8 tendons）, respectively. The results were completely consistent with the operative exploration. 53 patients were detected as the tendon connection, 10 patients had severe scar connection, and 13 patients had mild scar connection using high frequency ultrasound screen. In addition, the TAM evaluation result in experimental group was significant better compared to control group. Conclusion High frequency ultrasound can not only be used to accurate diagnosis of hand tendon and discrimination between tendon connection and scar connection, but also can appropriate position the tendon broken end and gradation of scar connection. Clinical postoperative treatment guiding by continuous monitoring of high frequency ultrasound can significantly improve the hand functional rehabilitation level of hand tendon rupture patients.

关 键 词：肌腱断裂 高频超声 瘢痕连接 

分 类 号：R473.6[医药卫生—护理学]