体外冲击波与超声引导下局部注射激素治疗跖筋膜炎的疗效分析  

Comparison of therapeutic effects between extracorporeal shock wave and ultrasound-guided local injection of hormones in the treatment of plantar fasciitis

作　　者：何晓飞[1] 高锋[2] 梁之孔 潘华燕 马牙南 张卫兵[3] He Xiaofei;Gao Feng;Liang Zhikong;Pan Huayan;Ma Yanan;Zhang Weibing(Department of Rehabilitation Physiotherapy,Jiangsu Corps Hospital of Chinese People’s Armed Police Force,Yangzhou 225003,Jiangsu,China;Department of Outpatient,Jiangsu Corps Hospital of Chinese People’s Armed Police Force,Yangzhou 225003,Jiangsu,China;Department of Ultrasound,Jiangsu Corps Hospital of Chinese People’s Armed Police Force,Yangzhou 225003,Jiangsu,China)

机构地区：[1]武警江苏总队医院康复理疗科,江苏扬州225003 [2]武警江苏总队医院门诊部,江苏扬州225003 [3]武警江苏总队医院超声科,江苏扬州225003

出　　处：《足踝外科电子杂志》2024年第4期8-13,共6页Electronic Journal of Foot and Ankle Surgery

摘　　要：目的分析比较体外冲击波与超声引导下注射激素治疗跖筋膜炎的临床疗效差异。方法选择2020年3月至2023年10月武警江苏总队医院因足跟疼痛而收治的跖筋膜炎患者78例,并将其以随机数表法分为两组,每组39例,A组采用体外冲击波治疗,B组采用超声引导下跖筋膜局部注射2%利多卡因2 ml+复方倍他米松注射液1 ml混合液治疗。观察治疗前及治疗后1周、4周、12周晨起足跟部疼痛视觉模拟评分(visual analogue scale,VAS)、美国足踝外科协会(American Orthopaedics Foot and Ankle Society,AOFAS)踝与后足评分,用超声测量跖筋膜厚度,记录治疗相关并发症。结果治疗后1周疼痛VAS评分A组高于B组,AOFAS踝与后足评分A组低于B组,跖筋膜厚度A组大于B组(P<0.001)。治疗后4周疼痛VAS评分、AOFAS踝与后足评分及跖筋膜厚度,两组比较差异无统计学意义(P>0.05)。治疗后12周疼痛VAS评分A组低于B组,AOFAS踝与后足评分A组高于B组,跖筋膜厚度A组小于B组。治疗后12周A组临床疗效优于B组(x^(2)=8.895,P=0.031)。结论体外冲击波与超声引导下注射激素治疗跖筋膜炎均有效,后者短期内缓解疼痛、改善功能明显,但前者的长期临床效果更佳。Objective To compare and analysis the clinical efficacy of extracorporeal shock wave and ultrasound-guided injection of hormones in the treatment of plantar fasciitis.Methods 78 patients with plantar fasciitis due to heel pain admitted to the Jiangsu Corps Hospital of Chinese People’s Armed Police Force from March 2020 to October 2023 were selected and randomly divided into two groups,39 cases in each group.Group A was treated with extracorporeal shock wave,group B was treated with ultrasound-guided local injection of 2%lidocaine 2 ml+compound betamethasone injection 1ml mixture into plantar fascia.The visual analogue scale(VAS)of heel pain,American Orthopaedics Foot and Ankle Society(AOFAS)ankle and hindfoot scores,and the thickness of plantar fascia were measured before and 1,4,and 12 weeks after treatment,and the treatment-related complications were recorded.Results one week after treatment,the pain VAS score in group A was higher than that in group B,the AOFAS ankle and hindfoot score in group A was lower than that in group B,and the plantar fascia thickness in group A was greater than that in group B(P<0.001).There was no significant difference in pain VAS score,AOFAS ankle and hindfoot score and plantar fascia thickness between the two groups 4 weeks after treatment(P>0.05).At 12 weeks after treatment,the pain VAS score in group A was lower than that in group B,the AOFAS ankle and hindfoot score in group A was higher than that in group B,and the plantar fascia thickness in group A was less than that in group B.The clinical efficacy of group A was better than that of group B at 12 weeks after treatment(x^(2)=8.895,P=0.031).Conclusion Both extracorporeal shock wave and ultrasound-guided injection of hormones are effective in the treatment of plantar fasciitis.The latter can relieve pain and improve function significantly in the short term,but the former has better long-term clinical effect.

关 键 词：跖筋膜炎 体外冲击波 超声引导 疼痛 

分 类 号：R68[医药卫生—骨科学]