超声介入与冲击波治疗肱二头肌长头腱鞘炎的临床研究

Clinical study of interventional ultrasound and shock wave treatment of tenosynovitis of long head of biceps brachii

目的研究肌骨超声介入下复方倍他米松注射治疗与放射式冲击波治疗对肱二头肌长头腱鞘炎的临床疗效。方法回顾性收集2014年12月至2016年11月山西大医院收治的72例经核磁共振成像(MRI)检查及查体均确诊为肱二头肌长头腱鞘炎的患者,根据不同治疗方法分为肌骨超声介入下复方倍他米松注射治疗组(超声介入组,n=42)及冲击波治疗组(n=30),分别于治疗前,治疗后即刻、1 w、2 w及5 w评定患侧肩的VAS评分、肩关节主动前屈关节活动度(AFROM)及肱二头肌抗阻力试验。结果超声介入组VAS评分下降、AFROM增加较冲击波治疗组明显,差异具有统计学意义(F=84.880,F=176.080,P<0.01);与冲击波治疗组相比,超声介入组的肱二头肌抗阻力试验治疗后1 w、2 w后肱二头肌抗阻力阳性率明显下降,差异具有统计学意义(x^2=64.286,x^2=54.460,P<0.01)。结论肌骨超声介入治疗肱二头肌长头腱鞘炎可快速缓解疼痛,改善肩关节活动度。

Objective To study the clinical curative effect of betamethasone injection guided by musculoskeletal ultrasound and radial shock wave therapy for tenosynovitis of long head of biceps brachii.Methods A respectively study performed in72patients of tenosynovitis of long head of biceps brachii by MRI admitted to Affiliated Hospital of Shanxi Medical University from December2014to November2016,they were diagnosed as and were divided into betamethasone injection guided by musculoskeletal ultrasound group(n=42)and radial shock wave therapy group(n=30)according to different treatment methods.VAS score,active shoulder flexion joint activity and biceps resistance test were recorded before treatment,immediately and1weeks,2weeks and5weeks after treatment.Results VAS score in betamethasone injection guided by musculoskeletal ultrasound group was decreased,while active flexion joint activity were lower than radial shock wave therapy group,difference was statistically significant(F=84.880,F=176.080,P<0.01).The positive rate of biceps resistance test in betamethasone injection guided by musculoskeletal ultrasound group at1week and2weeks after treatment were lower than radial shock wave therapy group,differences were statistically significant(c2=64.286,c2=54.460,P<0.01).Conclusion Musculoskeletal ultrasound intervention can quickly relieve the pain,improve the activity of shoulder join in the treatment of tenosynovitis of long head of biceps brachii.