发散式冲击波治疗拇指屈指肌腱狭窄性腱鞘炎临床观察

Clinical observation of RSWT in the treatment of tenosynovitis stenosus of flexor tendon of thumb

目的探索发散式冲击波与封闭治疗拇指屈指肌腱狭窄性腱鞘炎的临床疗效差异。方法将60例患者随机分成两组,每组30例。一组行常规糖皮质激素封闭治疗,另一组应用发散式冲击波治疗,在治疗后当时及治疗后的1、3及6个月对患者进行随访,通过视觉模拟评分(VAS),分析两组治疗效果。结果治疗前冲击波组与封闭组VAS评分差异无统计学意义(P>0.05),治疗后冲击波组VAS评分较治疗前有明显改善(P<0.05);封闭组无明显改善;两组在治疗后当时及治疗后的1、3及6个月VAS评分较治疗前均有明显改善,但冲击波组的总有效率明显高于封闭组。结论发散式冲击波治疗拇指屈指肌腱狭窄性腱鞘炎疗效优于封闭治疗。

Objective To observe the differences in clinical efficacy of radial extracorporeal shock wave and closed treatment in the treatment of flexor tendon stenosis of tenosynovitis of thumb.Methods 60 patients with flexor tendon stenosis of tenosynovitis of thumb were randomly divided into two groups with 30 cases in each group.One group was treated with glucocorticoid occlusion while the other was treated with radial extracorporeal shock wave.Follow-up interviews were given to patients at the time of treatment,1 month,3 months and 6 months after the treatment.The visual analogue scores(VAS)was adopted to analyze the clinical efficacy in the two groups.Results Before the treatment,the VAS of the two groups showed no statistical significance(P>0.05).After the treatment,the VAS of the shockwave group was significantly improved(P<0.05).No significant improvement was found in the closed treatment group.The VAS scores of the two groups were significantly improved at the time of the treatment and 1 month,3 months and 6 months after the treatment compared with those before the treatment.However,the efficacy of the shockwave group was significantly higher than that of the closed treatment group.Conclusion The efficacy of the treatment of flexor tendon stenosis of tenosynovitis by radial extracorporeal shock wave was better than that of the closed treatment.