发散式体外冲击波治疗距骨骨软骨损伤的效果  

Treatment of osteochondral lesions of the talus with radial extracorporeal shock wave

作　　者：刘水涛[1] 杨军[2] 史展[2] 张浩冲 邢更彦[1,2] 

机构地区：[1]第四军医大学西京医院骨科,西安710032 [2]武警总医院骨一科,北京100039

出　　处：《武警医学》2017年第7期694-697,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的评价发散式体外冲击波疗法治疗距骨骨软骨损伤的效果。方法选取2010-01至2016-06武警总医院就诊,并采用发散式冲击波治疗的距骨骨软骨损伤54例60个距骨,治疗方案为能量1.5~2.5 bar,5Hz,冲击2000~3000次,5次为一疗程,共治疗3~4疗程。治疗结束后3、6、12个月进行随访,通过患者踝关节VAS疼痛评分、美国足与踝协会踝与后足评分和MRI矢状面损伤面积大小评价治疗效果。结果治疗结束后3个月,患者VAS评分降低,AOFAS评分升高,与治疗前比较均有统计学差异(P<0.05)。治疗结束后6、12个月,患者踝关节疼痛持续缓解,功能评分不断提高(P<0.01);治疗前平均损伤面积(2.67±1.14)cm^2,治疗结束后3个月(1.97±0.77)cm2,6个月(1.04±0.61)cm^2和12个月(0.46±0.25)cm^2缩小更明显(P<0.01),部分患者损伤区可完全消失。结论发散式体外冲击波治疗轻中度距骨骨软骨损伤可获得良好疗效。Objective To evaluate the effect of the radial extracorporeal shock wave therapy on osteochondral lesions of the talus（ OLT）. Methods Between January 2010 and June 2016,54 cases of patients（ 60 taluses） were treated with radial shock wave.The treatment involved 1. 5-2. 5 bar,5 Hz,2000-3000 shocks every time. Five times were taken as a course of treatment,and a total of three or four courses were needed for a patient. The patients were followed up at three,six,and twelve months after treatment which was evaluated by the patients＇ ankle VAS pain score,the American Orthopaedic Foot and Ankle Society（ AOFAS） Ankle and Hindfoot Score,and the sagittal lesion area by MRI. Results Three months after treatment,the VAS score decreased while the AOFAS score increased,which was significantly different from that before treatment（ P〈0. 05）. Six,twelve months after treatment,the ankle pain continued to be eased,and the functional scores continued to improve（ P〈0. 01）. The lesion area was（ 2. 67 ± 1. 14） cm^2 before treatment,but was（ 1. 97 ± 0. 77） cm^2 three months after treatment,which was reduced obviously at 6 months（ 1. 04 ± 0. 61） cm^2 and 12 months（ 0. 46 ± 0. 25） cm^2（ P〈0. 01）,and even completely disappeared in some patients. Conclusions Radial extracorporeal shock wave can achieve good curative effect in the treatment of mild to moderate osteochondral lesions of the talus.

关 键 词：距骨骨软骨损伤 发散式体外冲击波 损伤面积 

分 类 号：R68[医药卫生—骨科学]