腓肠肌内侧头腱膜松解术和冲击波治疗单侧慢性足底筋膜炎疗效的对比研究  

Comparison of clinical efficacy of proximal medial gastrocnemius release and shock wave for treating unilateral chronic plantar fasciitis

作　　者：刘凤岐[1] 马立峰[1] 郭艾[1] 刁乃成[1] 杨波[1] Liu Fengqi;Ma Lifeng;Guo Ai;Diao Naicheng;Yang Bo(Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050)

机构地区：[1]首都医科大学附属北京友谊医院骨科,100050

出　　处：《国际外科学杂志》2019年第6期391-395,共5页International Journal of Surgery

摘　　要：目的 评价腓肠肌内侧头腱膜松解术治疗单侧慢性足底筋膜炎的有效性.方法 采用前瞻性研究方法,选择2018年1-7月在首都医科大学附属北京友谊医院骨科就诊的单侧慢性足底筋膜炎的患者56例,按照治疗方式将56例患者分为观察组(n=28)和对照组(n=28),其中男性33例,女性23例,年龄(48.1±6.2)岁,年龄范围43.9 ~57.1岁.观察组接受腓肠肌内侧头腱膜松解术治疗单侧慢性足底筋膜炎;对照组使用发散式体外冲击波治疗单侧慢性足底筋膜炎,每3d接受1次发散式体外冲击波治疗,每次冲击2 000次,共治疗5次.比较两组患者治疗前、治疗后3个月的视觉模拟评分(VAS)、美国骨科足踝外科协会踝-后足评分(AOFAS)和踝关节背伸角度.所有患者都获得门诊随访,随访(3.9±0.7)个月,随访内容包括足踝功能和疼痛情况,时间截止到2018年10月.正态分布的计量资料以均数±标准差(Mean±SD)的形式表示,组间比较采用t检验;计数资料组间比较采用x2检验.结果 观察组治疗前VAS、AOFAS和踝关节背伸角度分别为(6.9±0.8)分、(48.4±2.8)分和(10.8±3.9)°,治疗后3个月分别为(2.1±1.0)分、(82.8±3.6)分和(21.9±4.8)°,观察组治疗前、治疗后3个月差异有统计学意义(P<0.05).而对照组治疗前分别为(6.1±0.7)分、(49.1±2.8)分和(11.8±3.6)°,治疗后3个月VAS、AOFAS和踝关节背伸角度分别为(3.8±1.2)分、(56.0±3.6)分和(12.2±3.2)°,对照组治疗前、治疗后3个月VAS差异有统计学意义(P<0.05),AOFAS和踝关节背伸角度治疗前后差异无统计学意义(P>0.05).治疗后3个月,VAS、AOFAS和踝关节背伸角度结果比较,观察组优于对照组,两组之间差异有统计学意义(P<0.05).结论 腓肠肌内侧头筋膜松解术是治疗单侧慢性足底筋膜炎有效的手术方法,可解除疼痛并改善踝关节功能.Objective To explore the validity of proximal medial gastrocnemius release (PMGR) for treating unilateral chronic plantar fasciitis.Methods The prospective study was conducted.From January 2018 to July 2018,56 patients who were diagnosed chronic plantar fasciitis in Department of Orthopaedics,Beijing Friendship Hospital,Capital Medical University,were enrolled and divided into study group (n =28) and control group(n =28) according to different therapies.Fifty-six patients were enrolled including 33 males and 23 females,the age was (48.1 ±6.2) years (range,43.9-57.1 years).The patients in study group were treated with PMGR for unilateral chronic plantar fasciitis.Meanwhile,the patients in control group were treated by shock wave therapy,one extracorporeal shock wave therapy was accepted every 3 days,each impact 2 000 times,a total of five times.Visual analogue scale (VAS),the American orthopaedic foot and ankle hindfoot scale (AOFAS) and dorsal extension range of ankle joint of all patients before treatment and 3 months after treatment were recorded and compared.All the patients were outpatient followed for (3.9 ± 0.7) months until October 2018,the pain and function of feet were recorded.Measurement data with normal distribution were expressed as mean ± standard deviation (Mean ± SD).The data were statistically analyzed by t test between two groups.Count data were analyzed by chi-square test between two groups.Results In study group,preoperative VAS,AOFAS and dorsal extension angleof ankle joint were (6.9 ± 0.8) scores,(48.4 ± 2.8) scores and (10.8 ± 3.9) °,while 3 months after treatment VAS,AOFAS and dorsal extension angleof ankle joint were (2.1 ± 1.0) scores,(82.8 ± 3.6) scores and (21.9 ± 4.8)°.The difference between pre-operation and 3 months after treatment of study group was significant(P < 0.05).In control group,VAS,AOFAS and dorsal extension angle of ankle joint were (6.1 ± 0.7) scores,(49.1 ± 2.8) scores and (11.8 ± 3.6) ° before treatment,while VAS,AOFAS and dorsal extension range of ank

关 键 词：跖 筋膜炎 高能量冲击波 腓肠肌 

分 类 号：R687.2[医药卫生—骨科学]