腱鞘内注射联合半导体激光治疗狭窄性腱鞘炎的效果观察

Tendon sheath injection combined with semiconductor laser treating stenosal tendosynovitis

目的 探讨腱鞘内注射联合半导体激光治疗狭窄性腱鞘炎的临床效果.方法 将哈励逊国际和平医院2010年5月至2012年9月诊治的90例狭窄性腱鞘炎患者完全随机分为A、B、C组,每组30例.A组给予腱鞘内注射醋酸泼尼松龙注射液治疗,每次给予2％利多卡因1.5 ml＋醋酸泼尼松龙注射液0.5 ml混合液0.5～1 ml,1次/7 d,3次为1个疗程.B组采用半导体激光局部照射治疗,给予连续激光输出功率400～500 mW,集射探头垂直照射患处10 min,1次/d,10次为1个疗程.C组给予腱鞘内注射醋酸泼尼松龙联合半导体激光治疗.治疗后1个月,随访6个月对3组的临床疗效、复发率、平均治愈时间及不良反应进行观察比较.结果 C组总有效率、复发率、平均治愈时间与A、B组比较[总有效率：100.0％（30/30）比93.3％ （28/30）、90.0％ （27/30）;复发率：3.3％ （1/30）比16.7％ （5/30）、30.0％ （9/30）;平均治愈时间：（10±5）d比（14±7）、（18±8）d],差异均有统计学意义（均P＜0.05）.结论 腱鞘内注射醋酸泼尼松龙联合半导体激光治疗狭窄性腱鞘炎可取得良好疗效,综合疗效优于单一治疗.

Objective To explore the clinical effects of tendon sheath injection combined with semiconductor laser treating stenosal tendosynovitis.Methods Totally 90 cases with stenosal tenosynovitis were randomly divided into group A,B and C.Group A was given prednisolone acetate injections in the tendon sheath,0.5-1 ml mixed liquor of 2% lidocaine,1.5 ml and prednisone acetate 0.5 ml,once per 7 days for 3 times.Group B was given semiconductor laser local irradiation treatment,by continuous laser output power of 400-500 mW,beam probe vertical irradiation to the affected part for 10 min,once per day,10 times for a period of treatment.Group C was given injections of prednisolone acetate and semiconductor laser local irradiation treatment to the tendon sheath.1 month after treatment,clinical curative effects,recurrence rate and average healing time for the3 groups were observed and followed up for 6 months.Results Compared to group A and group B,there were significant differences in the total effective rate,recurrence rate and the average healing time of group C[total effective rate：100.0% （30/30） vs 93.3% （28/30）,90.0% （27/30） ;recurrence rate：3.3% （1/30） vs 16.7% （5/30）,30.0%（9/30）; average healing time：（10±5）dvs（14±7）,（18±8）d] （P〈0.05）.Conclusion Tendon sheath injection combined with semiconductor laser for the treatment of the stenosal tendosynovitis can achieve good curative effect.