封闭治疗桡骨茎突狭窄性腱鞘炎的新方案

The New Scheme Of Stenosing Tenosynovitis With Block

目的探讨不同封闭治疗方案对桡骨茎突狭窄性腱鞘炎疗效的影响。方法选取72例桡骨茎突狭窄性腱鞘炎患者,随机分为2组。对照组采用传统方案对桡骨茎突进行局部封闭治疗,观察组则在对照组基础上对患侧的前臂桡侧近端进行封闭治疗。比较治疗前、治疗后1周、4周、8周2组患者的视觉疼痛评分(VAS)及Cooney腕关节评分。结果 2组治疗后1周、4周、8周的VAS评分均较治疗前降低,Cooney腕关节评分较治疗前升高;但观察组治疗后各时间点的VAS评分显著低于对照组,Cooney腕关节评分明显高于对照组,差异均有统计学意义(P<0.05)。2组患者Finkelstein征阳性率治疗后8周分别降为33.3%、11.1%,观察组有效率明显高于对照组,差异均有统计学意义(P<0.05)。结论桡骨茎突局部与患侧前臂桡侧近端同时封闭,治疗效果优于单纯桡骨茎突局部封闭。

Objective To investigate the effects of different block treatment of radial styloid stenosing tenosynovitis. Methods Tottally 72 patients with radial stenosing tenosynovitis were randomly divided into control group and test group,control group was given local block at radial styloid process,the experimental group was at proximal radial forearm except for radial styloid process. Visual analogue scale（ VAS） 、Cooney score of Wrist joint function were evaluated in two groups before treatment,1,4 and 8 weeks after treatment. In addition,the positive rate of Finkelstein was compared with 8 weeks after treatment,and clinical curative effect was evaluated. Results The VAS score of two groups was in the 1st week,the 4th week and the 8th week after treatment significantly lower than that before treatment,especially in the experimental group. The VAS score was lower at each time point after treatment in the experimental group compared with that of the control group,the two groups after treatment in 1 weeks,4 weeks and 8 weeks Cooney wrist score was significantly higher than that before treatment,especially in the experimental group significantly; Cooney wrist score was lower at each time point after treatment in the experimental group compared with that of the control group. Finkelstein sign of the experimental and control group for 8 weeks after treatment were reduced to11. 1% vs 33. 3%,the experimental group was significantly higher than that of the control group. Conclusion The simultaneous block of the radial styloid process and proximal radial forearm is better than that of the radial styloid process.