针刀松解治疗指屈肌腱狭窄性腱鞘炎

Release with knife needle for the treatment of stenosing tenosynovitis of finger flexor tendon

目的:观察针刀松解治疗指屈肌腱狭窄性腱鞘炎的临床疗效和安全性。方法:将89例指屈肌腱狭窄性腱鞘炎患者随机分为2组,45例采用针刀松解治疗,44例采用局部封闭治疗。分别于治疗后3周和治疗后6个月,参照《中医病证诊断疗效标准》中指屈肌腱狭窄性腱鞘炎的疗效评定标准对2组患者的临床疗效进行评定和比较,并观察并发症发生情况。结果:治疗后3周,针刀组显效45例,封闭组显效25例、好转16例、无效3例,针刀组疗效优于封闭组(Z=-4.924,P=0.000)。治疗后6个月,针刀组显效43例、好转2例,封闭组显效19例、好转18例、无效7例;针刀组疗效优于封闭组(Z=-5.348,P=0.000)。2组患者均无神经、肌腱损伤及组织黏连等并发症发生。结论:针刀松解治疗指屈肌腱狭窄性腱鞘炎,可有效缓解疼痛、改善患指功能,安全可靠,疗效优于局部封闭治疗。

Objective：To observe the clinical curative effects and safety of knife needle release in the treatment of stenosing tenosyno-vitis of finger flexor tendon.Methods：Eighty-nine patients with stenosing tenosynovitis of finger flexor tendon were randomly divided into 2 groups,45 patients（knife needle group）were treated with percutaneous release with knife needle and 44 patients（blocking group）were trea-ted with local blocking therapy.The curative effect were evaluated and compared between the 2 groups at 3 weeks and 6 months after the treatment respectively by using the therapeutic effects evaluation standard of stenosing tenosynovitis of finger flexor tendon which was extrac-ted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes,and the complications were also observed.Results：Forty-five patients got a good result in the knife needle group,while 25 patients got a good result,1 6 fair and 3 poor in the blocking group at 3 weeks after the treatment.The knife needle group surpassed the blocking group in the curative effect（Z =-4.924,P =0.000）.Forty -three patients got a good result and 2 fair in the knife needle group,while 1 9 patients got a good result,1 8 fair and 7 poor in the blocking group at 6 months after the treatment.The knife needle group surpassed the blocking group in the curative effect（Z =-5.348,P =0.000）.No complications such as nerve injuries,tendon injuries and tissue adhesions were found in the 2 groups. Conclusion：Percutaneous release with knife needle can effectively relieve the finger pain and improve the finger function.It is safe and reli-able for treatment of stenosing tenosynovitis of finger flexor tendon,and its curative effect is better than that of local blocking therapy.