超高频超声在手指肌腱断裂诊断和预后评估中的应用效果分析  

Application effect of ultra-high frequency ultrasound in the diagnosis and prognosis evaluation of finger tendon rupture

作　　者：杨刘梅 廖鹏飞[1] 何咏斯 何蔚庄 YANG Liu-mei;LIAO Peng-fei;HE Yong-si(Panyu District Hospital of Traditional Chinese Medicine,Guangzhou 511400,China)

机构地区：[1]广州市番禺区中医院,511400

出　　处：《中国现代药物应用》2023年第3期87-89,共3页Chinese Journal of Modern Drug Application

摘　　要：目的 分析超高频超声在手指肌腱断裂诊断以及预后评估中的应用效果。方法 25例手指肌腱断裂患者,均接受超高频超声检查,并在术后进行肌腱康复训练指导。观察分析超高频超声的诊断结果以及术后患者肌腱恢复情况、不同阶段肌腱修复情况。结果 25例手指肌腱断裂患者手术结果显示:肌腱完全断裂患者17例,占比68%;部分断裂患者8例,占比32%;超高频超声检查结果显示:肌腱完全断裂患者18例,占比72%;部分断裂患者有7例,占比28%。超高频超声诊断符合率为96%(24/25)。术后超高频超声检查22例(88%)患者为肌腱性连接, 3例(12%)瘢痕连接。术后患者康复情况:Ⅰ级15例(60%)、Ⅱ级7例(28%)、Ⅲ级2例(8%)、Ⅳ级1例(4%),总恢复率为88%(22/25)。肌腱性连接的超声表现:肌腱吻合位置与健侧相比稍厚,内部回声均匀,边界清晰,被动运动滑动明显;瘢痕连接的超声表现:肌腱吻合部位增厚明显,不均匀内部回声,模糊边界,可见斑片状强回声,有周围组织粘连。于术后1~2周进行超高频超声检查,患者肌腱吻合处边界模糊、低回声、强回声斑;于术后3~4周检查发现:患者肌腱吻合处呈现清晰边界、纤维状强回声;于术后4周以后检查发现:肌腱吻合处回声较均匀并接近正常肌腱的为肌腱性连接;而肌腱吻合处表现明显增厚,边界模糊,伴有不均匀回声的则为瘢痕连接。结论 针对手指肌腱断裂的患者利用超高频超声诊断具有较高的准确率,能有效观察肌腱愈合情况,并指导患者进行科学合理的康复训练。Objective To analyze the application effect of ultra-high frequency ultrasound in the diagnosis and prognosis evaluation of finger tendon rupture. Methods All 25 patients with finger tendon rupture were examined by ultra-high frequency ultrasound and instructed in postoperative tendon rehabilitation, and the diagnostic results of ultra-high frequency ultrasound, postoperative tendon recovery and tendon repair at different stages were observed and analyzed. Results Among the 25 patients with finger tendon rupture, the surgical results showed that there were 17 patients(68%) with complete tendon rupture and 8 patients(32%)with partial rupture;the results of ultra-high frequency ultrasound showed that there were 18 patients(72%) with complete tendon rupture and 7 patients(28%) with partial rupture. The diagnosis coincidence rate of ultra-high frequency ultrasound was 96%(24/25). Postoperative ultra-high frequency ultrasound showed tendon junctions in 22 patients(88%) and scar junctions in 3 patients(12%). Postoperative patient recovery: gradeⅠin 15 cases(60%),grade Ⅱ in 7 cases(28%), grade Ⅲ in 2 cases(8%), and grade Ⅳ in 1 case(4%), with an overall recovery rate of 88%(22/25). Ultrasound performance of tendon junction: the tendon anastomosis location was slightly thicker compared with the healthy side, with uniform internal echogenicity, clear boundary, and obvious passive motion sliding;ultrasound performance of scar junction: the tendon anastomosis location was significantly thickened, with uneven internal echogenicity, fuzzy boundary, and patchy strong echogenicity, with surrounding tissue adhesion.The ultra-high frequency ultrasound examination was performed at 1-2 weeks postoperatively, the tendon anastomosis showed blurred border, hypoechoic and strong echogenic spots;at 3-4 weeks postoperatively, the tendon anastomosis showed clear border and fibrous strong echogenicity;at 4 weeks postoperatively, the tendon anastomosis showed more uniform echogenicity and was close to normal tendon;while the tendon

关 键 词：超高频超声 手指肌腱断裂 诊断 预后评估 

分 类 号：R686.1[医药卫生—骨科学] R445.1[医药卫生—外科学]