肌骨超声引导下针刀治疗手指屈肌狭窄性腱鞘炎临床研究  

Clinical Study on Musculoskeletal Ultrasound- Guided Acupotomy for Tenosynovitis Strictus Flexor of Fingers

作　　者：邱昌民 孟昭阳 林兵宾 章连新 俞建辉 QIU Changmin;MENG Zhaoyang;LIN Bingbin;ZHANG Lianxin;YU Jianhui(Department of Treating Disease Before Arising,Lanxi Hospital of Traditional Chinese Medicine,Lanxi Zhejiang 321100,China;Department of Rehabilitation,Lanxi Hospital of Traditional Chinese Medicine,Lanxi Zhejiang 321100,China;Department of Acupuncture and Moxibustion,Lanxi Hospital of Traditional Chinese Medicine,Lanxi Zhejiang 321100,China)

机构地区：[1]兰溪市中医院治未病科,浙江兰溪321100 [2]兰溪市中医院康复科,浙江兰溪321100 [3]兰溪市中医院针灸科,浙江兰溪321100

出　　处：《新中医》2023年第16期153-156,共4页New Chinese Medicine

基　　金：金华市中医药科技计划项目:科研基金/软科学研究计划项目(2017JZK22)。

摘　　要：目的:观察肌骨超声引导下针刀治疗手指屈肌狭窄性腱鞘炎(TF)的临床疗效及对手功能康复的影响。方法:选取80例TF患者为研究对象,根据随机数字表法分为观察组及对照组各40例。对照组给予传统针刀松解治疗,观察组给予肌骨超声引导下针刀松解治疗。比较2组临床疗效、手指功能Quinnell分级评分、患指血运与感觉恢复情况、关节弹响与绞索情况、疼痛情况、生活自理能力与并发症发生情况。结果:观察组总有效率为100%,对照组为90.00%,2组比较,差异有统计学意义(P<0.05)。术后1个月,观察组Quinnell分级评分低于对照组(P<0.05);观察组毛细血管充盈恢复时间、感觉恢复时间均短于对照组(P<0.05);观察组关节弹响、关节绞索发生率均低于对照组(P<0.05);观察组疼痛视觉模拟评分法评分低于对照组(P<0.05),Barther指数高于对照组(P<0.05)。术后1个月,观察组没有出现并发症,对照组并发症发生率为10.00%,2组比较,差异有统计学意义(P<0.05)。结论:肌骨超声引导下针刀治疗TF可提高临床疗效,有效减轻患指疼痛,减少关节弹响、绞索现象,从而提高其生活自理能力,加速患指功能康复,且无明显并发症发生。Objective:To observe the clinical effect of musculoskeletal ultrasound-guided acupotomy for tenosynovitis strictus flexor of fingers(TF)and its influence on hand function rehabilitation.Methods:A total of 80 TF patients were selected as study objects and divided into the observation group and the control group according to random number table method,with 40 cases in each group.The control group was given traditional acupotomy release treatment,and the observation group was given musculoskeletal ultrasound-guided acupotomy release treatment.The clinical effects,Quinnell grading score of finger function,recovery of blood flow and sensation,joint bounces and locking,pain,self-care ability and complications in the two groups were compared.Results:The total effective rate was 100%in the observation group and 90.00%in the control group,the difference being significant(P<0.05).One month after surgery,the Quinnell grading score in the observation group was lower than that in the control group(P<0.05);the capillary filling recovery time and sensory recovery time in the observation group were shorter than those in control group(P<0.05);the incidence of joint bounces and joint locking in the observation group was respectively lower than that in the control group(P<0.05);the Visual Analogue Scale(VAS)score in the observation group was lower than that in the control group(P<0.05),and the Barther index was higher than that in the control group(P<0.05).One month after surgery,there was no complication in the observation group,and the complication rate in the control group was 10.00%,the difference being significant(P<0.05).Conclusion:Musculoskeletal ultrasound-guided acupotomy can improve clinical effect on TF,effectively relieve the pain of the affected fingers and reduce joint bounces and locking,thereby improving patients self-care ability and advancing functional rehabilitation of the affected fingers,without complications.

关 键 词：手指屈肌狭窄性腱鞘炎 肌骨超声技术 针刀疗法 Quinnell分级评分 

分 类 号：R686.1[医药卫生—骨科学]