不同超声平面引导下小针刀治疗屈指肌肌腱狭窄性腱鞘炎的临床效果比较

Clinical Effect of Small Needle Knife Guided by Different Ultrasound Planes in Patients with Flexor Tendon Stenosis Tenosynovitis

目的:观察不同超声平面引导下小针刀治疗屈指肌肌腱狭窄性腱鞘炎(FTST)患者的临床效果。方法:选取2017年1月-2020年1月于本院就诊的70例FTST患者作为研究对象,按随机数字表法分为对照组和观察组,各35例。两组均在超声引导下行小针刀治疗,对照组于长轴平面外,观察组于短轴平面外。比较治疗后1周两组治疗效果,比较治疗前及治疗后1周两组毛细血管再充盈时间及毛细血管动脉频谱[收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)],比较治疗后1个月手指功能分级(Quinnell分级)。结果:治疗后1周,观察组治疗总有效率显著高于对照组(P<0.05);治疗后,两组毛细血管再充盈时间较治疗前显著缩短,且观察组明显短于对照组(P<0.05);两组PSV、EDV、RI较治疗前显著增高,且观察组明显高于同一时间对照组(P<0.05);治疗后1个月时,观察组手指功能明显优于对照组(P<0.05)。结论:短轴平面外超声引导下行小针刀治疗FTST患者较长轴平面外超声引导效果更佳,毛细血管动脉频谱指标及血流速度的恢复时间更短,对手指功能复旧有利。

Objective:To observe the clinical effect of small needle knife guided by different ultrasound planes in patients with flexor tendon stenosis tenosynovitis (FTST).Method:Seventy FTST patients who were treated in our hospital from January 2017 to January 2020 were selected as the study subjects,and divided into the control group and the observation group according to random number table method,35 cases in each group.Both groups were treated with small needle knife under ultrasound guidance,while the control group was out of the long axis plane and the observation group was out of the short axis plane.The therapeutic effect of the two groups was compared 1 week after treatment.The capillary refill time and capillary arterial spectrum[peak systolic velocity (PSV),end diastolic velocity (EDV),resistance index (RI)]of the two groups were compared before treatment and 1 week after treatment.The finger function (Quinnell grade) of the two groups were compared 1 month after treatment.Result:One week after treatment,the total effective rate of the observation group was significantly higher than that of the control group (P<0.05).One week after treatment,the capillary refill time of the two groups was significantly shorter than that before treatment,and the observation group was significantly shorter than that of the control group (P<0.05),the PSV,EDV,RI of the two groups were significantly increased than those before treatment,and the PSV,EDV,RI of the observation group were significantly higher than those of the control group (P<0.05).One month after treatment,the finger function of the observation group was significantly better than that of the control group (P<0.05).Conclusion:The small needle knife guided by ultrasound out of the short axis plane has better efficacy than by ultrasound out of the long axis plane in the treatment of FTST patients,and shorter recovery time of capillary arterial spectrum indexes and blood flow velocity,which is beneficial for the restoration of finger function.