改良针刀疗法治疗屈指肌腱狭窄性腱鞘炎临床观察

Clinical observation on modified acupotomy in treatment of flexor tendon stenosing tenosynovitis

目的观察改良针刀治疗屈指肌腱狭窄性腱鞘炎的临床疗效。方法将我院收治的屈指肌腱狭窄性腱鞘炎60例患者随机分为观察组与对照组各30例。观察组在肌骨超声引导下行改良针刀治疗,对照组行传统针刀治疗。比较两组患者治疗前后疼痛视觉模拟评分(VAS)、昆内尔分级(Quinnell),并评定两组临床疗效。结果观察组总有效率显著高于对照组(P<0.05);治疗后观察组即时及治疗后2周、治疗后4周随访VAS评分显著低于对照组(P<0.05),Quinnell分级显著低于对照组(P<0.05);观察组A1滑车腱鞘厚度显著低于对照组(P<0.05);观察组患指肌腱厚度显著高于对照组患者(P<0.05)。结论肌骨超声引导下采用改良针刀治疗屈肌腱腱鞘炎能够精准定位狭窄腱鞘,引导下松解狭窄腱鞘,疗效确切,安全性高。

Objective To observe the clinical efficacy of modified acupotomy in treatment of flexor tendon stenosing tenosynovitis.Methods A total of 60 cases of patients with flexor tendon stenosing tenosynovitis were randomly divided into observation group and control group,30 cases each.Observation group received improved acupotomy treatment under musculoskeletal ultrasound guidance,while control group received traditional acupotomy treatment.The Visual analogue scale(VAS)score and Quinnell grading of pain before and after treatment,were compared and the clinical efficacy of the two groups was evaluated.Results The total effective rate in observation group was significantly higher than control group after treatment(P<0.05);VAS scores of observation group immediately after treatment,2 weeks after treatment and 4 weeks after treatment were significantly lower than control group(P<0.05),and Quinnell scores immediately were significantly lower than those control group(P<0.05);the thickness of A1 pulley tendon sheath in observation group was significantly lower than control group(P<0.05);the thickness of affected finger tendon in observation group was significantly higher than control group(P<0.05).Conclusion Modified acupotomy in treatment of flexor tendon tenosynovitis under the guidance of musculoskeletal ultrasound can accurately locate the narrow tendon sheath and release the narrow tendon sheath under the guidance,which is effective and safe.