斜刃针刀治疗屈指肌腱鞘炎的解剖学及临床研究

Anatomic and Clinical Research of Oblique Blade Edge Acupotome in Treatment of Flexor Tenosynovitis

目的探讨斜刃针刀在治疗屈指肌腱鞘炎上的解剖机理以及优势。方法观测各指屈指肌腱鞘环状韧带A1环的宽度及体表定位,分别采用特型斜刃针刀和I型4号针刀治疗屈指肌腱鞘炎患者各24例,3个月后随访患者疗效及症状的改善程度。结果环状韧带A1总体平均宽度约为7.0mm;治疗组总有效率优于对照组,有显著性差异(P<0.05)。两组VAS评分治疗前后比较,均有极显著性差异(P<0.01);治疗前后VAS评分差值组间比较,有显著性差异(P<0.05)。结论斜刃针刀治疗屈指肌腱鞘炎的目的主要是通过切开腱纤维鞘A1环,解除对屈指肌腱的束缚,能显著改善屈指肌腱鞘炎患者的临床症状及体征,远期疗效优于I型4号针刀,值得临床推广。

Objective To investigate anatomical mechanism and superiority on oblique edge acupotome in the treatment of flexor tenosy -novitis.Method Observation for each finger flexor tendon sheath width and surface location of the annular ligament of A 1 rings, respective-ly, using special oblique blade acupotome and I type 4 acupotome for the treatment of tenovaginitis of flexor digitorum of the 24 cases of pa-tients, improve the degree and effect of symptoms after 3 months of follow -up of patients.Results The average width of the annular liga -ment of total A1 is about 7.0mm;The effecy of the two groups ：the treatment group 20 cases were cured, 4 cases improved, the total efficien-cy was 100%, control group 16 cases were cured, 4 cases improved, 4 cases ineffective, the total efficiency of 83.33%.Comparing the two groups, statistically, there was significant difference （P〈0.05）.Two groups of VAS score before and after the treatment group compared with statistical treatment, there were significant differences （P〈0.01）, before and after treatment,compare the score difference between the groups, there was significant difference （P〈0.05）.Conclusion Oblique blade acupotome treatment of tenovaginitis of flexor digitorum purpose is mainly through the incision and tendinous sheath A 1, the lifting of the shackles of flexor tendon , can obviously improve the clinical symptoms and signs of muscle flexor tenosynovitis of patients , long -term efficacy is superior to the I type 4 acupotome, is worthy of clinical spread.