两种模式聚焦超声治疗慢性软组织损伤性疼痛的评估及比较

发布时间：2018-03-02 14:56

本文选题：聚焦超声　切入点：慢性软组织损伤　出处：《重庆医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的评估高强度聚焦超声间断治疗慢性软组织损伤性疼痛的有效性及安全性,并比较其与低强度聚焦超声持续治疗慢性软组织损伤性疼痛的差异,拟指导临床应用。方法100名符合慢性软组织损伤性疼痛诊断的患者,均给予相同的药物治疗,随机分为LG、HG两组,每组50人。低强度聚焦超声组(LG: Low focused ultrasound group):以患者于治疗部位能感受到(酸、麻、胀、痛)的最小聚焦超声强度,持续治疗10min。高强度聚焦超声组(HG: High focused ultrasound group):以患者可以耐受的最大聚焦超声强度分次治疗,每次治疗1min,间歇lmin,共治疗10次。观察各组治疗前后NRS评分、痛阈改变情况、生活质量量表(SF-36)及抑郁量表(BDI)评分,并记录不良反应。结果1)两组患者治疗后NRS评分、BDI评分与治疗前比较明显降低(P0.05),治疗部位及小腿胫前机械痛阈明显增高,差异有统计学意义(P0.05)；2)SF-36量表8个维度评价中,躯体疼痛(BP)、精力(VT)、社会功能(SF)、精神健康(MH)4个维度及心理健康评分(MCS)两组治疗前后均有明显差异(P0.05),而生理机能(PF)、生理职能(RP)、一般健康状况(GH)、情感职能(RE)4个维度及生理健康总评(PCS)两组治疗前后变化均无统计学意义(P0.05)。3)组间比较,LG治疗后NRS评分降低,与HG比较有统计学差异(P0.05)。SF-36评分8个维度中,BP、VT 2个维度评分增加与HG组比较差异有统计学意义(P0.05),但两组治疗后痛阈、BDI评分改变差异无统计学意义(P0.05)。4)LG、HG两组不良反应发生率分别为0%、8%,不良反应发生率两组比较,差异有统计学意义(P0.05)。结论高强度聚焦超声间断治疗慢性软组织损伤性疼痛有效；与高强度聚焦超声间断治疗比较,以患者在治疗部位能感受到(酸、麻、胀、痛)的最小聚焦超声强度连续治疗效果更好,副作用更小。
[Abstract]:Objective to evaluate the efficacy and safety of intermittent high-intensity focused ultrasound (HIFU) in the treatment of chronic soft tissue injury pain, and to compare the efficacy and safety of HIFU with low intensity focused ultrasound (LIFU) in the treatment of chronic soft tissue injury pain. Methods 100 patients who met the diagnosis of chronic soft tissue injury pain were treated with the same drug and were randomly divided into LGG group and LGHG group. Low intensity focused ultrasound (LIFU) group: Low focused ultrasound group: the minimum intensity of focused ultrasound (acid, anesthesia, distension, pain) was felt at the site of treatment. HG: High focused ultrasound group was treated with HG: High focused ultrasound group for 10 minutes. The patients were treated with the maximum intensity of focused ultrasound for 10 times. The NRS score and pain threshold were observed before and after treatment, and the changes of pain threshold were observed before and after the treatment. Results 1) after treatment, the scores of NRS score and BDI score were significantly lower than those before treatment, and the mechanical pain threshold of the treatment site and the leg before treatment were significantly higher than those before treatment, and the scores of SF-36) and depression scale were recorded in the two groups. 1) after treatment, the scores of NRS and BDI were significantly lower than those before treatment, and the mechanical pain threshold of the treatment site and the leg before treatment were significantly increased. The difference was statistically significant in 8 dimensions of SF-36 scale. There were significant differences between the two groups in the four dimensions of somatic pain, energy, social function, social function, mental health and mental health before and after treatment (P 0.05), while the physiological function of PFN, physiological function, general health status, emotional function and emotional function were 4 dimensions and 4 dimensions, respectively, and the birth of the two groups were all significant differences before and after the treatment (P0. 05%, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P < 0. 05). There was no significant difference between the two groups before and after treatment (P 0.05). 3) the NRS scores of the two groups were lower than those of the group treated with LG, and there was no significant difference between the two groups before and after treatment. There was statistical difference between HG and HG in the eight dimensions of P0.05 SF-36 score. There was a significant difference between HG group and HG group in the increase of BP5 VT score. However, there was no significant difference in BDI score between the two groups after treatment. There was no significant difference in the incidence of adverse reactions between the two groups. The birth rate was 0% and 8% respectively. The incidence of adverse reactions was compared between the two groups. Conclusion High intensity focused ultrasound is effective in the treatment of chronic soft tissue injury pain. The effect of continuous treatment with minimal focused ultrasound intensity was better and the side effect was less.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614

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