儿童拇指扳机指局部封闭治疗的疗效分析

Clinical outcomes of steroid injection for treatment of pediatric trigger thumbs

目的分析局部封闭治疗儿童拇指扳机指的疗效。方法2007年8月至2009年2月，对41例（47指），年龄20个月至5岁，病程时间为1周至4年的儿童拇指扳机指，按照Sugimoto分期，其中Ⅱ期27指、Ⅲ期17指、Ⅳ期3指，均采用局部封闭治疗，每周1次，共2－3次。结果2例Ⅱ型拇指扳机指失访，其余39例45指获得随访，时间为12－18个月，平均14个月。局部封闭治疗后平均2周症状缓解，总有效率为82．2％。注射局部无后遗症。结论局部封闭治疗儿童拇指扳机指起效快，是安全有效的保守治疗方法。

Objective To analyze the clinieal effectiveness of steroid injection for treatment a pediatric trigger thumbs. Methods From August 2007 to February 2009, there were 47 trigger thumbs （15 right thumbs, 20 left thumbs, 6 bilateral） in 41 children （15 boys, 26 girls）, that had been treated with steroid injection in our hospital. The steroid injection was performed once a week for a total of 2 or 3 times. The age at initial diagnosis ranged from 20 months to 5 years old, and the age at initial onset ranged from 1 week to 4 years. The severity of the trigger thumbs was classified using Sugimoto classification： there were 27 thumbs at stage If, 17 thumbs at stage Ⅲ, and 3 thumbs at stage IV. Results Two thumbs of stage Ⅱ were lost to follow-up. The rest 39 cases and 45 thumbs were followed for 12 to 18 months, with an average of 14 months. Symptom alleviation was noticed 2 weeks after the injection. The overall effective rate was 82.2%. No complication was found in injection rites. Conclusion It is a rapid and effective way to treat pediatric trigger thumbs with steroid injection.