超声引导与解剖定位肱骨外上髁注射消炎镇痛液治疗肱骨外上髁炎的比较

Application analysis of the treatment of external humeral epicondylitis by different methods of external humeral epicondyle injection

目的分析超声引导下与解剖定位下肱骨外上髁注射消炎镇痛液治疗肱骨外上髁炎的疗效及安全性。方法60例肱骨外上髁炎患者,采用随机数字表法分为超声引导组(U组)和痛点注射组(P组),每组30例。P组采用痛点局部注射消炎镇痛液治疗肱骨外上髁炎;U组采用超声引导下肱骨外上髁注射消炎镇痛液治疗肱骨外上髁炎。记录两组患者治疗前、首次治疗后2、4、12、24周的视觉模拟疼痛评分(visual analogue scores,VAS)、HSS2肘关节功能评分(hospital for special surgery scoring system 2)、治疗总花费、满意度评分及并发症发生情况。结果两组患者治疗后2、4、12、24周的VAS评分均较治疗前显著下降,HSS2肘关节功能评分均较治疗前显著升高(P<0.05)。两组间同一时间点VAS评分及HSS2肘关节功能评分比较,差异无统计学意义(P>0.05)。U组患者平均治疗费用较P组患者高,U组患者满意度较P组低,两组间差异有统计学意义(P<0.05)。结论痛点局部注射与超声引导下肱骨外上髁注射消炎镇痛液治疗肱骨外上髁炎均安全有效,短期内超声引导下肱骨外上髁注射未见明显的优越性。

Objective To analyze the efficacy and safety of injection of anti-inflammatory and analgesic fluid into external humeral epicondyle under ultrasound guidance and anatomical location on the treatment of tennis elbow.Methods Sixty patients with tennis elbow were randomly divided into Group U and P,with 30 cases in each group.Patients of Group P received local injection of anti-inflammatory and analgesic solution at pain points.In the Group U,the external epicondyle of the humerus was injected with anti-inflammatory and analgesic solution guided by ultrasound.Visual analogue scores(VAS)and hospital for special surgery scoring system 2(HSS2)were recorded before treatment and 2 weeks,4 weeks,12 weeks and 24 weeks after the first treatment.The total cost,satisfaction score and complications of the two treatments were calculated.SPSS17.0 software was used for statistical analysis.Results The VAS scores 2,4,12 and 24 weeks after treatment were significantly lower than before treatment in both groups,and HSS2 elbow function scores 2,4,12 and 24 weeks after treatment were significantly higher than before treatment in both groups(P<0.05).There was no significant difference in VAS score and HSS2 elbow function score between the two groups.The average treatment time of Group U was significantly longer than that of the Group P.The patient satisfaction of Group U was significantly lower than that of the Group P(P<0.05).There were no complications in either group.Conclusion Both local injection of pain point and ultrasound-guided injection of anti-inflammatory and analgesic fluid into external humerus epicondyle are safe and effective in the treatment of tennis elbow.In the short term,there is no obvious superiority in ultrasound-guided injection of external humerus epicondyle.