超声引导下针刀治疗跖间神经瘤的临床研究

The Clinical Study on Ultrasound-Guided Needle-KnifeTherapy of Morton’s Neuroma

目的:评估在超声引导下针刀治疗跖间神经瘤的临床疗效。方法:纳入从2017年1月至2020年1月诊断为跖间神经瘤的患者74例,采用随机数字表方法将患者分为针刀疗法组(治疗组)和封闭疗法组(对照组)。治疗组采用超声引导下针刀松解治疗,对照组采用传统封闭注射治疗。通过观测术前、术后1周和术后6个月的疼痛视觉模拟量表(VAS)评分及美国足踝外科学会踝-后足评分量表(AOFAS)评分评估两组患者术后疗效。结果:两组患者术后1周VAS评分及AOFAS评分均较治疗前明显改善,差异有统计学意义(P<0.05)。术后6个月治疗组评分仍较术前明显改善,但对照组较术前差异无统计学意义(P>0.05)。结论:超声引导下针刀疗法可通过精准松解跖间横韧带及神经旁软组织治疗跖间神经瘤,操作简单方便,短中期疗效优于封闭疗法,值得推广应用。

Objective:To evaluate the clinical efficacy of ultrasound-guided needle-knife treatment for interstitial neuroma.Methods:Patients diagnosed with interstitial neuroma in hospital from January 2017 to January 2020 were included. The 74 patients were divided into needle-knife therapy(treatment group) and block therapy(control group) using a random number table. The treatment group was treated with ultrasound-guided needle-knife release, and the control group was treated with traditional closed injection. The visual analogue scale(VAS) and American orthopaedic foot & ankle society(AOFAS) scores before, one week and six months after surgery were used to evaluate the efficacy of the two groups.Results:The VAS and AOFAS of one week after operation in both groups were significantly improved compared with those before treatment(P<0.05). However, the score in the treatment group was still significantly improved compared with that before surgery, but the control group had no significant difference compared with that before surgery(P>0.05).Conclusion:Ultrasound-guided needle-knife therapy can accurately treat Morton’s neuroma by loosening the intermetatarsal transverse ligament and paraneural soft tissue. The operation is simple and convenient, and the short-to-medium-term efficacy is better than closed therapy. It is worth of promoting.