超声引导下针刀松解治疗拇指屈指肌腱狭窄性腱鞘炎的临床效果

摘要/Abstract

摘要： 目的探讨拇指屈指肌腱狭窄性腱鞘炎患者采用超声引导下针刀松解治疗的临床效果。方法选取2023年1月—2024年1月平凉市中医医院收治的60例拇指屈指肌腱狭窄性腱鞘炎患者作为研究对象,以随机数表法分成对照组和研究组,每组30例。对照组给予盲穿针刀松解治疗,研究组给予超声引导下针刀松解治疗,比较两组临床疗效、疼痛程度、手指功能、总主动活动度（TAM）、A1滑车参数及并发症。结果研究组治疗总有效率高于对照组,差异有统计学意义（P<0.05）。治疗后,两组疼痛程度数字评分法（NRS）评分均下降,且研究组NRS评分低于对照组,差异有统计学意义（P<0.05）。研究组手指功能、TAM优于对照组,差异有统计学意义（P<0.05）。治疗后,两组A1滑车长度、厚度下降,且研究组各项指标低于对照组,差异有统计学意义（P<0.05）。研究组并发症发生率低于对照组,差异有统计学意义（P<0.05）。结论给予拇指屈指肌腱狭窄性腱鞘炎患者超声引导下针刀松解治疗,能够提升临床疗效,降低疼痛程度,改善手指功能、TAM,调节A1滑车参数,安全性较高。

关键词: 拇指屈指肌腱狭窄性腱鞘炎, 超声引导, 针刀松解, 疼痛程度, 手指功能

Abstract: Objective To investigate the clinical effect of ultrasound-guided needle-knife release therapy on patients with constricted tenosynovitis of flexor tendon of thumb. Methods A total of 60 patients with constricted tenosynovitis of flexor tendon of thumb admitted to Pingliang Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were randomly divided into control group and study group,each consisting of 30 cases. The control group was given blind needle-knife release treatment, and the study group was given ultrasound-guided needle-knife release treatment.The clinical efficacy, pain degree, finger function, total active range of motion (TAM),A1 trochlear parameters and complications were compared between the two groups. Results The total effective rate of treatment in the study group was higher than that in the control group, with a statistically significant difference (P<0.05). After treatment, both groups showed a decrease in the Numerical Rating Scale (NRS) for pain intensity, and the NRS score in the study group was lower than that in the control group, with a statistically significant difference (P<0.05). The finger function and TAM of the study group were better than those of the control group, with a statistically significant difference (P<0.05). After treatment, both groups experienced a reduction in A1 trochlear length and thickness, and the study group had lower values for all indicators compared to the control group, with a statistically significant difference (P<0.05). The incidence of complications in the study group was lower than that in the control group, with a statistically significant difference (P<0.05). Conclusion Ultrasound-guided needle-knife release therapy can improve clinical efficacy, reduce pain, improve finger function, TAM, adjust A1 trochlear parameters, and has high safety in patients with flexor tendon stenosis tenosynovitis of thumb.

Key words: constrictive tenosynovitis of flexor tendon of thumb, ultrasonic guidance, acupotomy release, degree of pain, finger function

中图分类号:

R246.9

胡琼, 何志荣, 胡雪. 超声引导下针刀松解治疗拇指屈指肌腱狭窄性腱鞘炎的临床效果[J]. 中华养生保健, 2025, 43(11): 51-55.

HU Qiong, HE Zhi-rong, HU Xue. Clinical Effect of Ultrasound-Guided Needle-Knife Release in the Treatment of Flexor Tendon Stricture Tenosynovitis of Thumb[J]. ZHONGHUA YANGSHENG BAOJIAN, 2025, 43(11): 51-55.

参考文献

[1] 孟颖博,王学昌,张董喆,等.弧刃针45°腱鞘切开松解术治疗拇指指屈肌腱狭窄性腱鞘炎[J].中国疼痛医学杂志,2022,28(6):467-470.
[2] 施娟娟,陆瑾,范刚启,等.浮针治疗Ⅰ、Ⅱ度屈指肌腱狭窄性腱鞘炎38例[J].中国针灸,2022,42(4):419-420.
[3] 王燕玲,林树东.超声引导下腱鞘内注药术联合针刀松解术治疗狭窄性腱鞘炎的临床分析[J].临床医学工程,2021,28(6):731-732.
[4] 于川,王庆甫,宗晨钟,等.超声引导下针刀联合拇长屈肌激痛点灭活治疗拇指狭窄性腱鞘炎的临床效果[J].中国医药导报,2023,20(15):146-150.
[5] 胥少汀,葛宝丰,徐印坎.实用骨科学(第4版)[M].北京:人民军医出版社,2012:1885-1888.
[6] QUINNELL R C.Conservative management of trigger finger[J].Practitioner,1980,224(1340):187-190.
[7] 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.
[8] FARRAR J T,PRITCHETT Y L,ROBINSON M,et al.The clinical importance of changes in the 0 to 10 numeric rating scale for worst,least,and average pain intensity: analyses of data from clinical trials of duloxetine in pain disorders[J].Pain,2010,11(2):109-118.
[9] 潘达德,顾玉东,侍德,等.中华医学会手外科学会上肢部分功能评定试用标准[J].中华手外科杂志,2000,16(3):130.
[10] 陈腾. 针刀镜下腱鞘松解与开放手术治疗指屈肌腱狭窄性腱鞘炎的效果比较[J].中国医学创新,2022,19(16):93-96.
[11] 黄雯松,毛泽江,王将勇,等.针刀镜下腱鞘松解术治疗指屈肌腱狭窄性腱鞘炎的临床研究[J].中国医学创新,2021,18(28):113-117.
[12] 龚龙. 超声引导下针刀治疗指屈肌腱狭窄性腱鞘炎80例[J].中国药业,2022,31(S2):344-346.
[13] 胡月,王信亭,张东宁,等.超声引导下药物注射联合针刀松解治疗拇指屈指肌腱狭窄性腱鞘炎[J].中国临床研究,2022,35(4):512-516.
[14] 马迎存,孟颖博,王学昌,等.弧刃针45°腱鞘切开松解术与传统针刀松解术治疗中重度拇指屈指肌腱狭窄性腱鞘炎临床研究[J].世界科学技术-中医药现代化,2024,26(1):268-274.
[15] 壮健,张超,颜华伦,等.超声引导下经皮针刀松解联合类固醇激素注射治疗扳机指[J].中国医学影像技术,2023,39(11):1615-1618.
[16] 雷光磊,陈思伶,贾海滨,等.肌骨超声引导小针刀治疗屈指肌腱狭窄性腱鞘炎的有效性及对患者预后的影响[J].重庆医学,2021,50(S2):35-38.
[17] 陈信,张琼方,吴章祥,等.超声引导下针刀松解A1滑车治疗拇指屈指肌腱狭窄性腱鞘炎的临床观察[J].影像研究与医学应用,2023,7(10):188-190,193.
[18] 蒋喜文,周龙.超声引导下针刀治疗屈指肌狭窄性腱鞘炎的临床研究[J].现代医用影像学,2022,31(3):581-584.
[19] 邱昌民,孟昭阳,林兵宾,等.肌骨超声引导下针刀治疗手指屈肌狭窄性腱鞘炎临床研究[J].新中医,2023,55(16):153-156.
[20] 陈宏建,曹蕊,茆在梅.肌骨超声引导小针刀治疗屈指肌腱狭窄性腱鞘炎的临床疗效[J].影像研究与医学应用,2023,7(12):194-196.