体外冲击波治疗髋关节滑膜炎的临床疗效

Clinical efficacy of extracorporeal shock wave therapy for the treatment of hip joint synovitis

目的探讨体外冲击波治疗髋关节滑膜炎的临床效果。方法将80例髋关节滑膜炎患者随机分为观察组与对照组各40例,对照组给予口服西乐葆、外敷伤柏膏、患肢制动和适当功能锻炼等治疗,观察组以痛点为中心行体外冲击波治疗,同时结合患肢制动和适当功能锻炼。比较两组治疗前、治疗后1个月、6个月及12个月的视觉模拟评分法(VAS)、髋关节活动度(Harris评分),以及随访12个月后的髋关节活动度优良率、不良反应发生率、复发率和疗程。结果治疗后,两组的VAS均随时间延长而降低(P<0.05),且观察组各时间点的评分均低于对照组(P<0.05),Harris评分均随时间延长而升高(P<0.05),且观察组治疗后各时间点的评分均高于对照组(P<0.05)。观察组的髋关节活动度优良率高于对照组(P<0.05),并发症发生率、复发率和疗程均低于或短于对照组(P<0.05)。结论 ESWT是治疗髋关节滑膜炎的有效方法,可显著缓解疼痛、改善髋关节活动度、缩短疗程、降低复发率,且无明显不良反应。

Objective To explore the clinical efficacy of extracorporeal shock wave therapy（ESWT） for the treatment of hip joint synovitis. Methods Eighty patients with hip joint synovitis were randomly divided into observation group or control group,with 40 cases in each group. The treatment of the control group included oral administration of celebrex, external application with Shangbaigao dressing, restraint of affected extremity, and proper functional exercise. The observation group received ESWT combined with restraint of affected extremity and proper functional exercise. Before treatment, at 1 month,6 months and 12 months after treatment, Visual Analogues Scale （VAS） and the activity of hip joint（ Harris score） were compared between the two groups. After 12-month follow-up,the excellent and good rate of hip joint activity, incident rates of complications and recurrence, and therapeutic course were also compared between the two groups. Results After treatment, VASs of both groups decreased over the time（ P 〈 O. 05 ）, with the score at each time point lower in the observation group than in the control group （ P 〈 0.05 ）, while Harris scores of both groups increased over the time （ P 〈 0.05 ）, with the score at each time point higher in the observation group than in the control group （ P 〈 0.05 ）. The excellent and good rate of hip joint activity was higher, incident rates of complications and recurrence lower, and the therapeutic course was shorter in the observation group compared to the control group（P 〈 0.05）. Conclusion ESWT is an effective approach for hip joint synovitis, for it can relieve the pain,improve activity of hip joint,shorten therapeutic course,and reduce the recurrence with no obvious complication.