[1]王宝剑 黄沪△ 常青 孙武 高春雨 时宗庭 张暑岚.肌骨超声引导下针刀治疗屈指肌腱狭窄性腱鞘炎的临床观察[J].中国中医骨伤科杂志,2019,27(03):29-32.
 WANG Baojian HUANG Hu CHANG Qing SUN Wu GAO Chunyu SHI Zongting ZHANG Shulan.Clinical Observation of Musculoskeletal Ultrasound Guided Needle-knife on the Flexor Tendon Stenosis Tenosynovitis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2019,27(03):29-32.
点击复制

肌骨超声引导下针刀治疗屈指肌腱狭窄性腱鞘炎的临床观察()
分享到:

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第27卷
期数:
2019年03期
页码:
29-32
栏目:
临床论著
出版日期:
2019-02-28

文章信息/Info

Title:
Clinical Observation of Musculoskeletal Ultrasound Guided Needle-knife on the Flexor Tendon Stenosis Tenosynovitis
文章编号:
1005-0205(2019)03-0029-04
作者:
王宝剑1 黄沪2△ 常青2 孙武1 高春雨1 时宗庭2 张暑岚2
1中国中医科学院望京医院(北京,100102) 2北京中医药大学第三附属医院
Author(s):
WANG Baojian1 HUANG Hu2△ CHANG Qing2 SUN Wu1 GAO Chunyu1 SHI Zongting2 ZHANG Shulan2
1Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing100102,China;2The Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100029,China.
关键词:
肌骨超声 针刀 屈指肌腱狭窄性腱鞘炎
Keywords:
musculoskeletal ultrasound needle knife flexor tendon stenosis tenosynovitis
分类号:
R686.1
文献标志码:
A
摘要:
目的:评价超声定位下针刀治疗屈指肌腱狭窄性腱鞘炎的临床疗效,超声下测量并总结A1滑车形态及其位置,使该操作趋向精准化。方法:回顾2016年2月至2018年2月期间在北京中医药大学第三附属医院门诊患者,采用超声引导下针刀治疗屈指肌腱狭窄性腱鞘炎患者60例(69指),于术前、术后2周及术后1个月收集患指A1滑车厚度、Quinnell分级以及VAS 评分值,并进行分析比较。同时于术前测量并标记A1滑车厚度、宽度、与掌横纹远端的距离及其与指动脉的距离。结果:术前后A1滑车厚度、Quinnell分级以及VAS评分分别行单因素重复测量方差分析,差异有统计学意义(P<0.01)。测得患指A1滑车平均厚度1.54 mm,A1滑车平均宽度6.70 mm,A1滑车近缘与掌横纹平均距离3.20 mm,A1滑车中线距两侧指动脉的平均距离8.00 mm.结论:肌骨超声引导下针刀治疗屈指肌腱狭窄性腱鞘炎的疗效确切,安全性高。超声直视下的A1滑车形态及其位置使该治疗趋向精准化,有利于该技术的普及和推广。
Abstract:
Objective:To evaluate the clinical efficacy of ultrasound-guided needle-knife therapy for trigger finger(TF).The shape and position of A1 pulley were measured and summarized under ultrasound to make the operation more accurate.Methods:A retrospective study was made on 60 patients(69 fingers)with TF treated by Needle-knife under ultrasound guidance from February 2016 to February 2018 in the outpatient department of the Third Affiliated Hospital of Beijing University of Chinese Medicine.The thickness of A1 pulley,Quinnell grade and VAS score were collected and analyzed before operation,2 weeks after and 1 month after operation.Meanwhile,the thickness and width of A1 pulley,its distance with nerves and vessles were measured and marked before operation.Results:Before and after operation,A1 pulley,Quinnell grade and VAS score were analyzed by single factor repeated measurement variance(P<0.01),with significant difference(P<0.05).The average thickness of A1 pulley was 1.54 mm,the average width of A1 pulley was 6.70 mm,the average distance between the proximal side of A1 pulley and the palmar transverse lines was 3.20 mm,and the average distance between the middle line of A1 pulley and the finger arteries on both sides was 8.00 mm.Conclusion:Needle-knife guided by musculoskeletal ultrasound is effective and safe in the treatment of stenosing tenosynovitis of flexor tendon.The morphology and location of A1 trolley summarized under the direct vision of ultrasound make the treatment more accurate,which is conducive to popularization and promotion.

参考文献/References:


[1] 陈孝平.外科学[M].7版.北京:人民卫生出版社,2010:1021.
[2] 胥少汀,葛宝丰,徐印坎.实用骨科学[M].3版.北京:人民军医出版社,2005:1587.
[3] 朱国文,金杰,吕一,等.屈指肌腱狭窄性腱鞘炎的诊治研究进展[J].中医正骨,2008,20(11):70-72.
[4] THORPE A P.Results of surgery for trigger finger[J].J Hand Surg(Br),1988,13(2):199-201.
[5] 国家中医药管理局.中医病证诊断疗效标准[S].北京:人民卫生出版社,1994:192.
[6] QUINNELL R C.Conservative management of trigger finger[J].Practitioner,1980,224(1340):187-190.
[7] DEVESA J M,VICENTE R,AHRAIRA V.Visual analogue scales for grading faecal incontinence and quality of life; their relationship with the Jorge-Wexner score and Rockwood scale[J].Tech Coloproctol,2013,17(1)67-71.
[8] 支绍钢,王岳锋.高频超声诊断手与腕部狭窄性腱鞘炎的应用价值[J].齐齐哈尔医学院学报,2012,33(1):49.
[9] 陈彩,杨柳,贾永恒,等.高频超声在手部狭窄性腱鞘炎诊断中的应用[J].中国中西医结合影像学杂志,2013,11(2):178-179.
[10] 惠华伟,徐大超,韩玉培.高频超声对手腕部腱鞘炎的诊断价值[J].中国社区医师,2015,31(12):119-120.
[11] SERAFINI G,DERCHI LE,QUADRI P,et al.High resolution sonography of the flexor tendons in trigger fingers[J].J Ultrasound Med,1996,15(3):213-219.
[12] 汪学松,陈丹,崔正礼,等.骨性突起与狭窄性腱鞘炎相关解剖学的临床研究[J].中国临床康复,2003,7(23):3024-3025.
[13] HUESTON J T,WILSON W F.The aetiology of trigger finger explained on the basis of intratendinous architecture[J].Hand,1972,4(3):257-260.
[14] 耿虹,董乐乐,朱文毅,等.狭窄性腱鞘炎病理改变及病理分型研究[J].包头医学院学报,2011,27(1):1-2.
[15] HOANG D,LIN A C,ESSILFIE A.Evaluation of percutaneous first annular pulley release:efficacy and complications in a perfused cadaveric study[J].J Hand Surg Am,2016,41(7):165-173.
[16] MISHRA S R,GAUR A K,CHOUDHARY M M,et al.Percutaneous a1 pulley release by the tip of a 20-g hypodermic needle before open surgical procedure in trigger finger management[J].Techniques in Hand and Upper Extremity Surger,2013,17(2):112-115.
[17] DAHABRA I A,SAWAQED I S.Percutaneous trigger finger release with 18-gauge needle[J].Saudi Med J,2007,28(7):1065-1067.
[18] LIU W C,LU C K,LIN Y C,et al.Outcomes of percutaneous trigger finger release with concurrent steroid injection[J].Kaohsiung J Med Sci,2016,32(12):624-629.

备注/Memo

备注/Memo:
1中国中医科学院望京医院(北京,100102)
2北京中医药大学第三附属医院
通信作者 E-mail:xhwy10010@qq.com
更新日期/Last Update: 2019-02-28