超声引导针刀松解术在四肢末端病的临床解剖学中的应用研究

Study of ultrasound guided needle knife release in of clinical anatomical extremity diseases

目的探讨超声引导针刀松解术在四肢末端病中的安全性和准确性。方法于北京大学医学部人体解剖学教研室选取福尔马林固定过的人体标本20具,研究时间为2019年3月至2022年6月。将标本分为传统操作组及超声引导组,每组10具,并在同一入路途径下进行针刀松解操作,传统操作组在非可视条件下进行针刀松解操作,超声引导组在高频探头引导下进行操作。针刀松解操作后留针,逐层解剖,观测针刀路径,比较桡骨茎突狭窄性腱鞘炎、屈指肌狭窄性腱鞘炎、腕管综合征、踝管综合征4种疾病传统操作及超声引导下操作的成功率、准确性、损伤率。结果超声引导组中腕管综合征的操作成功率高于传统操作组,差异有统计学意义(P<0.05);超声引导组中屈指肌狭窄性腱鞘炎、腕管综合征、踝管综合征的操作松解效率均高于传统操作组,差异有统计学意义(P<0.05);超声引导组操作损伤率低于传统操作组,差异有统计学意义(P<0.05)。结论超声引导下针刀松解技术在四肢末端病操作的安全性及准确性高,值得临床推广。

Objective To investigate the safety and accuracy of ultrasound guided needle knife release in extremity disease.Methods Twenty human specimens fixed with formalin were selected from the Department of Human Anatomy,School of Basic Medical Sciences,Peking University,the study was conducted from March 2019 to June 2022.Specimens were divided into traditional operation group and ultrasonic guided group,with ten specimens in each group,and the needle knife release operation was carried out under the same approach.The traditional operation group performed the needle knife release operation under invisible conditions,while the ultrasonic guided group performed the operation under the guidance of the high frequency probe.After the operation of needle loosening,the needle was kept,dissected layer by layer,and the needle path was observed,the success rate,accuracy and injury rate of conventional operation and ultrasound guided operation were compared in four diseases of radial stylostenosis tenosynovitis,flexor constriction tenosynovitis,carpal tunnel syndrome,and malleolar tunnel syndrome.Results The success rate of operation on carpal tunnel syndrome in ultrasound guided group was higher than that in traditional operation group,and the difference was statistically significant(P<0.05).The operation release efficiency of flexor stenosis tenosynovitis,carpal tunnel syndrome,and ankle tunnel syndrome in ultrasound guided group was higher than that in traditional operation group,and the differences were statistically significant(P<0.05).The operation injury rate of ultrasound guided group was lower than that of traditional operation group,and the difference was statistically significant(P<0.05).Conclusion Ultrasound guided needle knife release technique has high safety and accuracy in the operation of terminal extremity diseases,which is worthy of clinical promotion.