便携式超声引导骶髂关节注射在官兵军事训练伤救治中的应用与思考

Portable ultrasound⁃guided sacroiliac joint injection in the treatment of military training injuries:application and thinking

目的 探讨便携式超声引导下骶髂关节注射在治疗基层官兵军事训练伤导致骶髂关节痛中的安全性及有效性。方法 收集2020年4月至2022年4月海军军医大学第一附属医院疼痛治疗科收治的33例军事训练伤致骶髂关节痛官兵的临床资料,完善各项检查后,采用患者健康问卷(PHQ9)、7项广泛性焦虑障碍(GAD7)量表评估官兵是否存在焦虑、抑郁,使用便携式超声引导骶髂关节注射类固醇激素治疗。记录并比较治疗前和治疗后30 min、1周、4周的疼痛视觉模拟量表(VAS)评分,在治疗前和治疗后第4周进行Oswestry功能障碍指数(ODI)、睡眠状况自评量表(SRSS)评分,以官兵疼痛程度、活动度、睡眠情况及并发症发生情况评估临床疗效;治疗4周后进行满意度调查。结果 共有33例官兵纳入该研究,其中3例(9.10%)官兵存在抑郁或焦虑。超声引导下骶髂关节注射均顺利完成,官兵的VAS、ODI、SRSS评分分别由治疗前的(6.27±0.80)分、(72.45±9.54)分、(40.70±6.47)分改善至治疗后第4周的(2.97±1.26)分、(37.64±10.99)分、(20.61±6.02)分,差异均有统计学意义(P<0.05)。官兵诊疗的总体满意率为96.97%。结论 采用便携式超声引导骶髂关节注射安全、有效,具有携带方便、操作简单等优点,适用于官兵军事训练伤后骶髂关节痛的治疗,随访临床效果较好,可为海军作战保障舰船及基层部队的卫生兵提供借鉴和参考。

Objective To explore the safety and efficacy of portable ultrasound‐guided sacroiliac joint injection in the treatment of sacroiliac joint pain caused by military training injuries of grass‐roots officers and soldiers.Methods The clinical data of officers and soldiers with sacroiliac joint pain caused by military training injuries treated in The First Affiliated Hospital of Naval Medical University from April 2020 to April 2022 were collected.Necessary examinations were completed.Patient Health Questionnaire‐9(PHQ9)and 7‐item Generalized Anxiety Disorder Questionnaire(GAD7)were used to evaluate anxiety and depression.Portable ultrasound‐guided sacroiliac joint injection with steroid hormone was adopted.Visual analogue scale(VAS)scores were recorded before treatment and 30 min,1 week and 4 weeks after treatment.Oswestry disability index(ODI)and self‐rating scale of sleep(SRSS)were evaluated before treatment and 4 weeks after treatment.The clinical efficacy was evaluated by pain degree,mobility,sleep quality,and complications.Satisfaction survey was conducted 4 weeks after treatment.Results A total of 33 officers and soldiers were enrolled,and 3(9.10%)of them suffered from depression or anxiety.Portable ultrasound‐guided sacroiliac joint injection was successfully completed.The scores of VAS,ODI and SRSS at the 4th week after treatment were significantly lower than those before treatment(6.27±0.80 vs.2.97±1.26,72.45±9.54 vs.37.64±10.99,40.70±6.47 vs.20.61±6.02,P<0.05).The overall satisfaction of officers and soldiers was 96.97%.Conclusion Portable ultrasound‐guided sacroiliac joint injection is safe,effective,easy to operate.It is suitable for the treatment of sacroiliac joint pain after military training injuries,and clinical efficacy is good during follow‐up.It can provide reference for medics in naval combat support ships and grass‐roots units.