超声引导下介入治疗在军事训练软组织损伤中的应用研究

Application of ultrasound-guided interventional therapy for soft tissue injury caused by military training

目的评价超声在诊断军事训练软组织损伤、超声引导下介入治疗及术后监测随访中的应用价值。方法选取2015年6月至2018年6月于空军军医大学第一附属医院检查的军事训练伤官兵患者198例,所有患者均对损伤部位进行超声检查,结合患者病情及意愿,选择保守治疗或行超声引导下介入治疗,所有患者均于治疗后1~3个月进行随访,依据超声检查结果及临床症状改善情况分为治愈、好转和无明显变化。总有效率=治愈率+好转率。比较2种治疗方法的疗效,分析军事训练伤超声表现及随访结果。结果198例确诊为军事训练伤软组织损伤的患者中,131例接受超声引导下介入治疗,67例采取保守治疗。131例接受超声引导下介入治疗的患者中治愈99例,好转30例,无明显变化2例,总有效率为98.5%;67例接受保守治疗的患者中治愈26例,好转24例,无明显变化17例,总有效率为74.6%,2者总有效率比较差异有统计学意义(χ^2=29.05,P<0.05)。在治疗有效的各种类型软组织损伤患者中,超声随访均表现为厚度、回声、血流等较治疗前情况好转或恢复正常。结论高频超声能够准确诊断军事训练软组织损伤,精准定位实时引导微创治疗,并可动态监测康复情况,值得临床推广应用。

Objective To evaluate the value of ultrasound in the diagnosis,interventional therapy and postoperative monitoring and follow-up of soft tissue injury caused by military training.Methods From June 2015 to June 2018,198 officers or soldiers with soft tissue injury caused by military training who were examined at the First Affiliated Hospital of Air Force Military Medical University were selected.All patients underwent ultrasound examination of the injured sites.According to the patients'condition and wishes,one group received conservative treatment and the other group received ultrasound-guided interventional treatment.All patients were followed for 1~3 months after treatment.According to the results of ultrasound examination and the improvement of clinical symptoms,the patients were divided into three groups:cured,improved,and unchanged.Total effective rate was calculated ascure rate+improvement rate.The therapeutic effects of the two methods were compared,and the ultrasonic manifestations and follow-up results of soft tissue injury caused by military training were analyzed.Results Among 198 patients with soft tissue injury caused by military training,131 received ultrasound-guided interventional therapy and 67 received conservative treatment.Among 131 patients who received ultrasound-guided interventional therapy,99 were cured,30 improved,and 2 unchanged;the total effective rate was 98.5%.Among 67 patients who received conservative therapy,26 were cured,24 improved,and 17 unchanged;the total effective rate was 74.6%.The total effective rate was significantly higher in the ultrasound-guided interventional treatment group than in the conservative treatment group(χ^2=29.05,P<0.05).In patients with various types of soft tissue injuries that were effectively treated,ultrasound follow-up showed that the thickness,echo,and blood flow were improved or returned to normal.Conclusion High frequency ultrasound can accurately diagnose soft tissue injury caused by military training,locate and guide the minimally invasive treatment in real time,and dynamically monitor the rehabilitation situation,which is worthy of clinical application.