小针刀结合十字交叉缝扎法治疗腱鞘囊肿临床研究

Clinical Study on Small Needle Knife Combined with Cross Suture Ligation for Tendon Sheath Cyst

目的:观察小针刀结合十字交叉缝扎法治疗腱鞘囊肿的临床疗效。方法:纳入96例腱鞘囊肿患者,随机分为3组各32例,A组采用小针刀结合十字交叉缝扎法治疗,B组采用囊肿抽吸联合激素封闭法治疗,C组予手术治疗。比较3组患者的视觉模拟评分法(VAS)疼痛评分、临床疗效、复发率、感染率及住院费用。结果:治疗后1 d,A组及B组的VAS疼痛评分均低于C组(P<0.01);A组的VAS疼痛评分与B组比较,差异无统计学意义(P>0.05)。治疗后1周,A组及B组的VAS疼痛评分均低于C组,差异均有统计学意义(P<0.01);A组的VAS疼痛评分与B组比较,差异无统计学意义(P>0.05)。治疗后1个月,3组VAS疼痛评分比较,差异无统计学意义(P>0.05)。治疗后1年,A组的临床疗效优于B组(P<0.05);A组、B组与C组比较,差异均无统计学意义(P>0.05)。随访1年,A组复发率低于B组(P<0.05);A组、B组与C组比较,差异均无统计学意义(P>0.05)。3组均无患者发生感染。整个治疗周期内,A组的住院费用低于B组及C组(P<0.01);B组的住院费用低于C组(P<0.01)。结论:小针刀结合十字交叉缝扎法治疗腱鞘囊肿的治愈率与手术切除相近,但局部不会残留手术疤痕,且短期疼痛水平更低,治疗费用远低于手术切除;与囊肿抽吸联合激素封闭法相比,小针刀结合十字交叉缝扎法可以降低复发率。

Objective:To observe the clinical effect of small needle knife combined with cross suture ligation for tendon sheath cyst.Methods:A total of 96 cases of patients with tendon sheath cyst were randomly divided into three groups,with 32 cases in each group.Group A was treated with small needle knife combined with cross suture ligation;Group B was treated with cyst aspiration and hormone blockade;Group C was treated with operation.Pain scores in Visual Analogue Scale(VAS),clinical effects,recurrence rates,infection rates and hospitalization expenses among the three groups were compared.Results:One day after treatment,the VAS pain scores in Group A and Group B were lower than that in Group C(P<0.01);there was no significant difference being found in the comparison of VAS pain scores between Group A and Group B(P>0.05).One week after treatment,VAS pain scores in Group A and Group B were lower than that in Group C,differences being significant(P<0.01);there was no significant difference being found in the comparison of VAS pain scores between Group A and Group B(P>0.05).One month after treatment,there was no significant difference being found in the comparison of VAS pain scores among the three groups(P>0.05).One year after treatment,the clinical effect in Group A was better than that in Group B(P<0.05).The clinical effect in Group A and Group B were similar to that in Group C(P>0.05).During the follow-up within one year,the recurrence rate in Group A was lower than that in Group B(P<0.05).The recurrence rate in Goup A and Group B were similar to that in Group C,there being no significance in the difference(P>0.05).No infection was found in the three groups.During the whole treatment,the hospitalization expense in Group A was lower than those in Group B and Group C(P<0.01);the hospitalization expense in Group B was lower than that in Group C(P<0.01).Conclusion:The cure rate of small needle knife combined with cross suture ligation for tendon sheath cyst is similar to that of surgical resection,but there is no locally residual surgical scar,the level of short-term pain is lower,and the treatment cost is much lower than surgical resection.When compared with cyst aspiration combined with hormone blockade,the therapy of small needle knife combined with cross suture ligation can reduce the recurrence rate.