发散式体外冲击波治疗跗骨窦综合征的疗效研究  

Efficacy of radial extracorporeal shock wave in the treatment of tarsal sinus syndrome

作　　者：刘水涛 李杨 顾挺帅 张杰 王志强 Liu Shuitao;Li Yang;Gu Tingshuai;Zhang Jie;Wang Zhiqiang(Department of Traumatic Orthopedic,Characteristis Medical Center of the Chinese People's Armed Police Force.Tianjin 300162,China)

机构地区：[1]武警特色医学中心骨创伤科,天津300162

出　　处：《中国医学前沿杂志（电子版）》2022年第11期23-27,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：武警特色医学中心科研创新团队:基于某部队医院军事体能训练伤防治方案的研究(DYCXTD0202)。

摘　　要：目的 研究发散式体外冲击波治疗跗骨窦综合征的临床疗效,并与封闭疗法进行比较。方法 选取2017年7月至2021年12月符合纳入标准的46例(51足)随机分为两组,封闭治疗组采用每周1次,共4次的发散式体外冲击波治疗;冲击波治疗组采用利多卡因加复方倍他米松局部封闭治疗。分别记录两组患者术前、术后即刻、术后6个月的视觉模拟评分法(Visual Analogue Score,VAS)和美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足功能评分、步态变化及并发症情况,将两组治疗效果进行对比。结果 冲击波治疗组与封闭治疗组均能有效缓解跗骨窦综合征患者局部疼痛(P<0.01),冲击波治疗组在治疗后即刻,疼痛评分(4.1±1.3)分,高于封闭治疗组(2.7±1.2)分(P<0.01),但治疗后6个月,冲击波治疗组疼痛评分(1.7±0.6)分,优于封闭治疗组(3.6±1.1)分(P<0.01)。两组患者AOFAS评分在治疗后均有提高(P<0.01),冲击波治疗组在治疗后6个月,AOFAS评分持续升高,为(92.5±6.6)分,明显优于封闭治疗组(79.1±13.6)分(P<0.01)。两组患者在治疗后步长均无明显变化,步速均较治疗前加快,在治疗后6个月冲击波治疗组(1.19±0.17)m/s步速明显优于封闭治疗组(1.14±0.15)m/s (P<0.05)。冲击波治疗组未出现严重并发症,封闭治疗组出现1例局部感染,经治疗后愈合。结论 发散式体外冲击波是治疗跗骨窦综合征的有效方法,治疗后6个月,足踝疼痛明显缓解,功能改善,加快步速,无严重并发症,比局部封闭疗法具有更好的疗效。Objective To study the clinical efficacy of radical extracorporeal shock wave in the treatment of tarsal sinus syndrome and compare it with blocktherapy.Method 46 patients(51 feet)who met the inclusion criteria from July 2017 to December 2021 were randomly divided into two groups.Shock wave group was treated with radical extracorporeal shock wave once a week,a total of four times;Blocking therapy group was treated with blocktreatment with lidocaine and compound betamethasone.The visual analogue scale(VAS),American orthopedic foot and ankle society(AOFAS)ankle-hindfoot function score and complications of the two groups were recorded before operation,immediately after operation and 6 months after operation,and the treatment effects of the 2 groups were compared.Result Both the shock wave therapy group and the block therapy group can effectively alleviate the local pain of patients with tarsal sinus syndrome(P<0.01).Immediately after treatment,the VAS of the shock wave treatment group(4.1±1.3)is higher than that of the blocking therapy group(2.7±1.2)(P<0.01),but 6 months after treatment,the VAS of the shock wave therapy group(1.7±0.6)is better than that of the blocking therapy group(3.6±1.1)(P<0.01).The AOFAS score of the two groups increased after treatment(P <0.01).The AOFAS score of the shock wave therapy group increased continuously(92.5±6.6)6 months after treatment,which was significantly better than that of the blocking therapy group(79.1±13.6)(P<0.01).No serious complications occurred in the shock wave therapy group.There was no significant change in the step length of the patients in both groups after therapy,and the step speed was faster than that before treatment.At 6 months after treatment,the step speed of the shock wave therapy group [(1.19±0.17)m/s]was significantly better than that of the blocking therapy group[(1.14±0.15)m/s](P <0.05).And 1 case of local infection occurred in the blocking therapy group,which healed after treatment.Conclusion Radical extracorporeal shock wave is an effective m

关 键 词：发散式体外冲击波 跗骨窦综合征 封闭治疗 步态分析 

分 类 号：R681.8[医药卫生—骨科学]