超声引导下针刀治疗儿童先天性拇指屈指肌腱狭窄性腱鞘炎的研究  

Ultrasound-Guided Acupotomy in the Treatment of Congenital Tenosynovitis of Flexor Tendon of Thumb in Children

作　　者：许权 杨凤云[1] 宋庆 徐鑫 曹端广 吴凡 张恒青 Xu Quan;Yang Fengyun;Song Qing(The Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang,Jiangxi,330000,China)

机构地区：[1]江西中医药大学附属医院,江西南昌330000

出　　处：《黑龙江医学》2025年第2期160-162,共3页Heilongjiang Medical Journal

基　　金：2022年度江西省卫生健康委科技计划项目(202210780)。

摘　　要：目的:在高频超声引导下采用小针刀治疗儿童先天性拇指屈指肌腱狭窄性腱鞘炎,探究其临床疗效及超声下拇长屈肌腱的特征。方法:选取2018年1月—2022年6月江西中医药大学附属医院治疗的60例先天性拇指屈指肌腱狭窄性腱鞘炎患儿作为研究对象,随机分为观察组(超声引导下针刀疗法组)和对照组(切开松解手术组),每组各30例。观察治疗前后拇指屈指肌腱在超声下A1滑车处宽度及厚度的改变、健侧及患指掌指关节处拇长屈肌腱的横截面积对比、疗效及并发症的情况。结果:两组患儿在治疗3个月前后,超声下A1滑车处宽度及厚度比较,差异无统计学意义(P>0.05);治疗前,两组患儿内健侧及患侧拇指掌指关节处拇长屈肌腱的横截面积比较,差异有统计学意义(P<0.05),两组患儿健侧及患侧在拇指掌指关节处拇长屈肌腱的横截面积比较,差异无统计学意义(P>0.05);观察组的治愈率(93.3%)明显高于对照组(83.3%),差异有统计学意义(P<0.05);两组患儿在治疗的全过程未出现并发症。结论:超声引导下小针刀治疗儿童先天性拇指屈指肌腱狭窄性腱鞘炎具有显著的疗效,安全可靠。Objective:To investigate the clinical effect and ultrasonic characteristics of flexor tendon of thumb long in the treatment of congenital stenosing tenosynovitis of flexor tendon of thumb with acupotomy guided by high-frequency ultrasound.Methods:60 children with congenital stenosing tenosynovitis of the flexor digitorum of the thumb in the hospital from January 2018 to June 2022 were randomly divided into observation group(ultrasound-guided acupotomy group)and control group(open and release operation group),with 30 cases in each group.The changes of the width and thickness of flexor tendon of thumb at trochlear A1 under ultrasound,the comparison of the cross-section area of flexor pollicis longis tendon at the healthy side and the metacarpophalangeal joint of the affected finger,the curative effect and complications were observed before and after treatment.Results:Before and after 3 months of treatment,there was no significant difference in the width and thickness of A1 pulley under ultrasound in each group(P>0.05).Before treatment,the cross-sectional area of flexor pollicis longis tendon at the metacarpophalangeal joint of the thumb on the healthy side and the affected side was significantly different among all groups(P<0.05),and the cross-sectional area of flexor pollicis longis tendon at the metacarpophalangeal joint of the thumb on the healthy side and the affected side was not significantly different among all groups(P>0.05).The cure rate of observation group(93.3%)was significantly higher than 83.3% of control group(P<0.05).There were no complications in the whole course of treatment in both groups.Conclusion:Ultrasound-guided acupotomy is effective,safe and reliable in the treatment of congenital tenosynovitis of thumb flexor tendon stenosis in children.

关 键 词：超声 针刀 拇指 屈指肌腱狭窄性腱鞘炎 儿童 

分 类 号：R686.1[医药卫生—骨科学]