肌骨超声引导下腱鞘内注射透明质酸酶治疗肱二头肌长头腱鞘炎的疗效观察  

Curative effect of intra-tendon sheath hyaluronidase injection guided by ultrasound in treating biceps brachii longitendosynovitis

作　　者：黄祯 梁桂生 王志坤 杨银广 Huang Zhen;Liang Guisheng;Wang Zhikun;Yang Yinguang(Department of Ultrasound,SSL Central Hospital of Dongguan,Dongguan 523326,China;Department of Rehabilitation,SSL Central Hospital of Dongguan,Dongguan 523326,China)

机构地区：[1]广东省东莞市松山湖中心医院超声科,523326 [2]广东省东莞市松山湖中心医院康复科,523326

出　　处：《中国医师杂志》2021年第12期1795-1799,共5页Journal of Chinese Physician

基　　金：广东省中医药局科研项目 (20190321232105)。

摘　　要：目的观察肌骨超声引导下腱鞘内注射透明质酸酶治疗肱二头肌长头腱鞘炎的疗效。方法选取2019年4月至2020年4月在东莞市松山湖中心医院接受治疗的134例肱二头肌长头腱鞘炎患者作为研究对象,以随机数字表法将所有患者分为普通注射组和超声辅助注射组各67例。普通注射组给予肩关节腔内注射透明质酸酶治疗,超声辅助注射组给予肌骨超声引导下腱鞘内注射透明质酸酶治疗。采用视觉模拟量表(VAS)评分、主动前屈关节活动度(AFROM)、肩关节活动度(ROM)、功能评分、前屈力量评分、核磁共振成像(MRI)、局部肱二头肌长头腱鞘炎测量(TLHBB),评价治疗后临床效果及术后并发症。结果普通注射组与超声辅助注射组患者性别、年龄、病程及肩周炎、肩关节周围肌肉废用性萎缩比例相比,差异无统计学意义(P>0.05)。治疗后,两组AFROM、ROM、功能评分、前屈力量评分、内侧开口角(MWA)显著高于治疗前(P<0.05),VAS评分及肱骨头最大直径(HHD)、肱二头肌长头肌腱直径(BTD)、TLHBB测量值显著低于治疗前(P<0.05)。超声辅助注射组AFROM、ROM、功能评分、前屈力量评分、MWA显著高于普通注射组(P<0.05),VAS评分、HHD、BTD、TLHBB测量值显著低于普通注射组(P<0.05)。超声辅助注射组治疗总有效率高于普通注射组(97.01%vs 85.07%,P<0.05)。结论肌骨超声引导下腱鞘内注射透明质酸酶可有效治疗肱二头肌长头腱鞘炎,减轻患者肩关节疼痛,提高肩关节活动功能。Objective To observe the effect of hyaluronidase injection into tendon sheath under muscle bone ultrasound guidance in the treatment of tenosynovitis of long head of biceps brachii.Methods 134 patients with tenosynovitis of the long head of biceps brachii treated in SSL Central Hospital of Dongguan from April 2019 to April 2020 were selected as the research objects.All patients were randomly divided into ordinary injection group and ultrasound-assisted injection group,67 cases in each group.The general injection group was treated with intra-articular injection of hyaluronidase,and the ultrasound-assisted injection group was treated with intra-tendon sheath injection of hyaluronidase under the guidance of muscle and bone ultrasound.Visual Analog Scales(VAS)score,active flexion joint motion(AFROM),shoulder range of motion(ROM),functional score,flexion strength score,nuclear magnetic resonance imaging(MRI)and local tenosynovitis of the long head of biceps brachii(TLHBB)were measured to evaluate the clinical effect and postoperative complications after treatment.Results There was no significant difference in gender,age,course of disease,periarthritis of shoulder and disuse atrophy of muscles around shoulder between ordinary injection group and ultrasound-assisted injection group(P>0.05).After treatment,the AFROM,ROM,function score,forward flexion strength score,and middle wedge angle(MWA)of the two groups were significantly higher than those before treatment(P<0.05),while the VAS score,humeral head diameter(HHD),biceps long head tendon diameter(BTD),and TLBBB were significantly lower than those before treatment(P<0.05).The AFROM,ROM,function score,and forward flexion strength score,MWA of the ultrasound-assisted injection group were significantly higher than those of the ordinary injection group(P<0.05),and the VAS score,HHD,BTD,and TLHBB were significantly lower than those of the ordinary injection group(P<0.05).The total effective rate of the ultrasound-assisted injection group was higher than that of the ordinary

关 键 词：超声检查 透明质酸酶 腱鞘炎 肱二头肌 

分 类 号：R686.1[医药卫生—骨科学]