体外冲击波治疗慢性跟腱炎的临床疗效

Clinical efficacy of extracorporeal shock wave therapy for chronic Achilles tendinitis

[目的]探讨体外冲击波治疗(extracorporeal shock wave therapy,ESWT)慢性跟腱炎的疗效。[方法]回顾性分析2017年6月—2021年10月于骨科门诊行ESWT治疗慢性跟腱炎患者187例。所有患者均接受5次ESWT,间隔1周,每次2000个脉冲(0.45 mJ/mm2,10Hz)。采用疼痛VAS和AOFAS踝与后足评分评价临床效果。[结果]所有患者治疗期间无严重不良反应,随访12个月以上。患者能够恢复运动情况,治疗后3个月为20.9%,6个月为69.0%,12个月时为86.1%。末次随访时,135例疼痛完全缓解,占72.2%;26例低强度运动时不引起疼痛,只在高强度运动时疼痛,占13.9%;10例日常生活不引起疼痛,只在体育运动时疼痛,占5.3%;16例仍然主诉疼痛,占8.6%。随时间推移(治疗前,治疗后3个月,治疗后6个月,治疗后12个月)患者VAS评分显著减小[(7.3±0.9)分,(2.8±0.7)分,(2.4±0.5)分,(2.0±0.7)分,P<0.05],而AOFAS评分显著增加[(72.1±4.7)分,(83.2±4.7)分,(87.2±3.7)分,(90.0±5.0)分,P<0.05]。[结论]冲击波治疗慢性跟腱炎操作简单,患者依从性好,安全有效。

[Objective]To explore the clinical efficacy of extracorporeal shock wave therapy(ESWT)for chronic Achilles tendinitis.[Methods]A retrospective study was conducted on 187 patients who received ESWT for chronic Achilles tendinitis in the outpatient department from June 2017 to October 2021.All patients received five ESWTs 1 week apart,each with 2000 pulses(0.45 mJ/mm2,10Hz).The clinical results were evaluated by pain VAS and AOFAS ankle and hindfoot scores.[Results]All patients had no serious adverse reactions during treatment,and were followed up for more than 12 months.The patients who were able to resume physical activity proved of 20.9%at 3 months,69.0%at 6 months,and 86.1%at 12 months after treatment.Of them,135 patients had pain completely relieved,accounting for 72.2%;26 patients had no pain in low intensity exercise,while pain in high-intensity exercise,accounting for 5.3%;10 patients had no pain in daily life,while pain only in exercise,accounting for 5.3%;16 patients continued to complain of pain,accounting for 8.6%at the latest follow-up.The VAS score for pain decreased significantly[(7.3±0.9),(2.8±0.7),(2.4±0.5),(2.0±0.7),P<0.05],while AOFAS score significantly increased[(72.1±4.7),(83.2±4.7),(87.4±3.7),(90.0±5.0),P<0.05]over time(befor treatment,3,6 and 12 months after treatment).[Conclusion]The extracorporeal shockwave therapy for chronic Achilles tendinitis is simple,safe and effective,with good patient’s compliance.