超声引导下糖皮质激素注射治疗单侧慢性跖筋膜炎的临床疗效观察  

Clinical efficacy of ultrasound-guided corticosteroid injection for treating unilateral chronic plantar fasciitis

作　　者：柳曦[1] 钱林学[1] 李谷锋 史宪全[1] 刘凤岐[3] 马立峰[3] LIU Xi;QIAN Lin-xue;LI Gu-feng(Department of Ultrasound,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Rehabilitative Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院超声科,北京100050 [2]首都医科大学附属北京友谊医院康复医学科,北京100050 [3]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《临床和实验医学杂志》2020年第13期1417-1421,共5页Journal of Clinical and Experimental Medicine

基　　金：北京市科委科技计划课题(编号:D121100004212003)。

摘　　要：目的探讨超声引导下注射糖皮质激素治疗单侧慢性跖筋膜炎的临床疗效。方法采用前瞻性研究方法,选取2019年1~10月首都医科大学附属北京友谊医院收治的单侧慢性跖筋膜炎患者63例,按照随机数字表法将患者分为对照组、压痛点注射组和超声引导下注射组,每组各21例。对照组患者使用发散式体外冲击波治疗跖筋膜炎,每3 d接受一次治疗,一共治疗5次;压痛点注射组在压痛点注射倍他米松注射液1 ml和利多卡因1 ml;超声引导下注射组在超声引导下将倍他米松注射液1 ml和利多卡因1 ml注射到跖筋膜深层。所有患者门诊随访12周。记录治疗前和末次随访时患者足部疼痛的视觉模拟评分(VAS)和足踝关节功能的美国足踝矫形协会(AOFAS)评分、末次随访患者的治疗有效率以及患者对治疗效果满意度,并进行比较。结果所有患者均得到完整随访。末次随访时对照组、超声引导下注射组和压痛点注射组的VAS分别是:4.2±0.4分、3.2±0.4分和4.0±0.5分,而三组AOFAS分别为48.5±4.7分、74.6±7.5分和49.4±5.2分。三组患者末次随访VAS评分均较治疗前显著下降,差异具有统计学意义(P<0.05)。超声引导下注射组VAS明显低于其他两组,差异具有统计学意义(P<0.05)。超声引导下注射组AOFAS评分明显高于其他两组,差异具有统计学意义(P<0.05)。而压痛点注射组和对照组AOFAS评分在治疗前后差异无统计学意义(P>0.05)。末次随访治疗有效率和患者满意度方面,超声引导下注射组明显高于压痛点注射组和对照组,差异具有统计学意义(P<0.05)。结论超声引导下注射糖皮质激素能够减轻单侧慢性跖筋膜炎疼痛,并且改善足踝功能,是治疗单侧慢性跖筋膜炎有效的非手术方法。Objective To investigate the efficacy of ultrasound-guided corticosteroid injection for the treatment of unilateral chronic plantar fasciitis.Methods A prospective study was performed from January 2019 to October 2019.In Beijing Friendship Hospital,Capital Medical University,Sixty-three patients who suffered unilateral chronic plantar fasciitis were enrolled and divided into three groups equally according to the method of random number table:control group observation group,palpation-guided injection group and ultrasound-guided injection group,21 cases in each group.The patients in control group were treated by radial extracorporeal shockwave therapy,one extracorporeal shockwave therapy was accepted every 3 days,a total of five times.The patients in palpation-guided injection group were treated by injection of 1 ml Dexamethasone mixed with 1 ml 1%Lidocaine.While the patients in ultrasound-guided injection group were treated by injection of 1 ml Dexamethasone mixed with 1 ml 1%Lidocaine deep to the plantar fascia.All the patients were outpatient followed for 12 weeks.VAS,AOFAS before treatment and final followed-up of all patients were recorded and compared.While effective rate and satisfaction rate of three groups were recorded and compared at final followed-up.Results All the patients were followed-up.At final followed-up,the VAS of control group,ultrasound-guided injection group and palpation-guided injection group were 4.2±0.4,3.2±0.4 and 4.0±0.5.While the AOFAS of control group,ultrasound-guided injection group and palpation-guided injection group were 48.5±4.7,74.6±7.5 and 49.4±5.2.For three groups,the difference of VAS between pre-treatment and final followed-up was significant(P<0.05).The VAS of ultrasound-guided injection group was lowest and the difference was significant compared with others(P<0.05).While AOFAS of ultrasound-guided injection group was highest and the difference was significant compared with others(P<0.05),The difference of foot and ankle joint function between pre-treatment and fin

关 键 词：慢性跖筋膜炎 超声引导 药物注射 高能量冲击波 功能恢复 

分 类 号：R445.1[医药卫生—影像医学与核医学] R686.3[医药卫生—诊断学]