超声介入与冲击波治疗肱二头肌长头腱鞘炎的临床研究

发布时间：2018-08-24 20:43

【摘要】：目的:1.研究放射式冲击波治疗对肱二头肌长头腱鞘炎的临床疗效;2.研究肌骨超声介入下复方倍他米松注射治疗对肱二头肌长头腱鞘炎的临床疗效;3.研究肌骨超声介入下复方倍他米松注射治疗与放射式冲击波治疗对肱二头肌长头腱鞘炎的临床疗效。方法:回顾性收集2014年12月至2016年11月山西医科大学附属大医院收治的72例经核磁共振成像(MRI)检查及查体均确诊为肱二头肌腱长头腱鞘炎的患者,根据不同治疗方法分为肌骨超声介入下复方倍他米松注射治疗(超声介入组,n=42)及放射式冲击波治疗(冲击波治疗组,n=30),分别于治疗前,治疗后即刻、1周、2周及5周评定患侧肩的VAS评分、肩关节主动前屈活动度(AFROM)及肱二头肌抗阻力试验(Speed试验)。结果:超声介入组患侧肩的VAS评分于治疗后各个时点与冲击波治疗组比较,均有所下降,超声介入组下降速度快且幅度大,尤其是治疗后即刻VAS评分下降最为明显,两组相比较差异有统计学意义(F=84.880,P0.01);超声介入组肩的AFROM于治疗后各个时点与冲击波治疗组所比较,活动度所增加,尤其在治疗后即刻、治疗后1周的AFROM增加最明显,两组相比较差异有统计学意义(F=176.080,P0.01);超声介入组的Speed试验于治疗后1周、2周与冲击波治疗组相比较,阳性率均有所下降,两组相比较差异具有统计学意义(χ2=64.286,χ2=60.182,P0.01)。结论:1.放射式冲击波治疗可以改善肱二头肌长头腱鞘炎局部疼痛及患者肩关节功能;2.肌骨超声介入下复方倍他米松精准注射治疗可快速、明显缓解肱二头肌长头腱鞘炎患者的肩痛,增加肩关节前屈活动度,提高肩关节功能,治疗作用持续且不易反复;3.肌骨超声介入下1次精准注射治疗较放射式冲击波5次治疗肱二头长头肌腱炎疗效显著,且经济价廉、明显缩短病程。
[Abstract]:Purpose 1. To study the clinical effect of radiation shock wave therapy on long head tenosynovitis of biceps brachii muscle. To study the clinical curative effect of compound betamethasone injection in the treatment of long head tenosynovitis of biceps brachii muscle. To study the clinical effect of compound betamethasone injection and radiation shock wave on long head tenosynovitis of biceps brachii muscle. Methods: from December 2014 to November 2016, 72 patients with long head tenosynovitis of biceps tendon were diagnosed by (MRI) and physical examination of Shanxi Medical University. According to the different treatment methods, the patients were divided into two groups: compound betamethasone injection therapy (ultrasound intervention group) and radiation shock wave therapy (shock wave treatment group: 30%). The VAS score of the affected shoulder, the active anterior flexion range (AFROM) and the anti resistance test of biceps brachii muscle (Speed test) were evaluated immediately after 1 week, 2 weeks and 5 weeks after treatment. Results: the VAS score of the affected shoulder in the ultrasound intervention group was lower than that in the shock wave treatment group at all time points after treatment. The ultrasonic intervention group had a fast and large decline rate, especially the VAS score decreased most obviously immediately after treatment. There was a significant difference between the two groups (FF84.880, P0.01), the AFROM of the shoulder in the ultrasound intervention group increased at each time point after treatment compared with that in the shock wave treatment group, especially immediately after treatment, the AFROM increased most obviously at 1 week after treatment. There was significant difference between the two groups (FF176.080, P0.01), and the positive rate of Speed test in the ultrasound intervention group was lower than that in the shock wave group at 1 week and 2 weeks after treatment, and the difference between the two groups was statistically significant (蠂 2 + 64.286, 蠂 2 + 60.182% P 0.01). Conclusion 1. Radiation shock wave therapy can improve local pain and shoulder function of patients with long head tenosynovitis of biceps brachii muscle. The precise injection of compound betamethasone under the intervention of musculoskeletal ultrasound can relieve the shoulder pain of patients with long head tenosynovitis of biceps brachii, increase the range of shoulder flexion, improve the function of shoulder joint, and the therapeutic effect is continuous and difficult to repeat. The treatment of single precise injection with ultrasound was more effective than that of radiation shock wave 5 times in the treatment of long head tendinitis of long head of brachium, and it was economical and cheap, and shortened the course of disease obviously.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R686

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