超声引导下不同型号针刀联合复方倍他米松注射液治疗扳机指的疗效对比  

Comparison of therapeutic effect of different types of acupotomies combined with compound betamethasone injection in the treatment of trigger finger under ultrasound guidance

作　　者：李春叶[1] 张倩[1] 王华[1] 谢荣[1] 张校瑜 LI Chunye;ZHANG Qian;WANG Hua;XIE Rong;ZHANG Xiaoyu(Department of Pain Clinic,Affiliated Hospital of Jiangsu University,Zhenjiang Jiangsu 212001,China)

机构地区：[1]江苏大学附属医院疼痛科,江苏镇江212001

出　　处：《江苏大学学报（医学版）》2024年第3期248-253,共6页Journal of Jiangsu University：Medicine Edition

基　　金：镇江市社会发展指导性科技计划项目(FZ2022089)。

摘　　要：目的:观察超声引导下不同型号针刀松解联合复方倍他米松注射液治疗扳机指的临床效果与安全性。方法:选取2020年5月至2023年5月江苏大学附属医院疼痛科诊断为扳机指患者111例为研究对象,将患者按随机数字表法进行简单随机化分为超声引导+复方倍他米松注射液组(Ⅰ组)36例、超声引导+复方倍他米松注射液+平口型针刀组(Ⅱ组)37例、超声引导+复方倍他米松注射液+V型针刀组(Ⅲ组)38例,随访为期6个月。记录3组治疗前(T1)、治疗后次日(T2)、治疗后3周(T3)、治疗后6个月(T4)的视觉模拟评分(VAS)和改良Quinnell分级,记录治疗6个月时整体改善状况(PGII)和复发率,以及手术操作时间和治疗期间不良反应。结果:①VAS评分比较:在T2时间点,Ⅱ组和Ⅲ组评分明显高于Ⅰ组(P<0.001),Ⅱ组评分明显高于Ⅲ组(P<0.05);在T3和T4时间点,Ⅱ组和Ⅲ组均明显低于Ⅰ组(P<0.05和P<0.001),Ⅱ组和Ⅲ组间无统计学差异(P>0.05)。②改良Quinnell分级比较:在T2、T3、T4时间点,Ⅱ组和Ⅲ组分级均明显低于Ⅰ组(P<0.05和P<0.001)、Ⅱ组和Ⅲ组间无统计学差异(P>0.05)。③治疗6个月PGII总体改善评分比较:Ⅱ组和Ⅲ组评分均明显高于Ⅰ组(P<0.001),Ⅱ组和Ⅲ组间无统计学差异(P>0.05)。④复发率比较:Ⅱ组和Ⅲ组均明显低于Ⅰ组(P<0.05),Ⅱ组和Ⅲ组间无统计学差异(P>0.05)。⑤操作时间比较:Ⅱ组和Ⅲ组均明显长于Ⅰ组(P<0.001),Ⅱ组时间明显长于Ⅲ组(P<0.05)。⑥3组均未见明显不良反应。结论:超声引导下针刀松解联合复方倍他米松注射液治疗扳机指效果优于单纯复方倍他米松注射液,V型针刀松解优于平口型针刀。Objective:To observe the clinical efficacy and safety of different types of needle knife combined with compound betamethasone injection under ultrasound guidance in the treatment of trigger finger.Methods:A total of 111 patients diagnosed with trigger finger in the Department of Pain Clinic Affiliated Hospital of Jiangsu University from May 2020 to May 2023 were selected as the study objects.The patients were randomly divided into three groups:groupⅠ(n=36),groupⅡ(n=37)and groupⅢ(n=38).GroupⅠ:ultrasound guidance+compound betamethasone injection alone group,groupⅡ:ultrasound guidance+compound betamethasone injection+flat mouth needle knife group,groupⅢ:ultrasound guidance+compound betamethasone injection+V type needle knife group,the follow-up period was 6 months.The visual analogue score(VAS),modified Quinnell grade were recorded before treatment(T1),the next day after treatment(T2),3 weeks after treatment(T3)and 6 months after treatment(T4),as well as the patient global impression of improvement(PGII)and recurrence rate at 6 months of treatment,operation time,adverse reactions were recorded.Results:①Comparison of VAS score:At T2 time point,the score of groupⅡand groupⅢwas significantly higher than that of groupⅠ(P<0.001).The score of groupⅡwas significantly higher than that of groupⅢ(P<0.05).At T3 and T4 time points,the scores in groupⅡand groupⅢwere significantly lower than those in groupⅠ(P<0.05 and P<0.001).There was no significant difference between groupⅡand groupⅢ(P>0.05).②Comparison of improved Quinnell grading:At T2,T3 and T4 time points,the grade in groupⅡand groupⅢwas significantly lower than that in groupⅠ(P<0.05 and P<0.001).There was no significant difference in grade between groupⅡand groupⅢ(P>0.05).③Comparison of PGII overall improvement scores:The scores of groupⅡand groupⅢwere significantly higher than those of groupⅠ(P<0.001).There was no significant difference between groupⅡand groupⅢ(P>0.05).④Comparison of recurrence rate:It was signi

关 键 词：扳机指 超声引导 平口型针刀 V型针刀 针刀松解术 

分 类 号：R686.1[医药卫生—骨科学]