超声引导下与盲目注射类固醇治疗腕管综合征的疗效比较
Effectiveness of Ultrasound-Guided Compared to Blind Steroid Injections in the Treatment of Carpal Tunnel Syndrome.
作者信息
Evers Stefanie, Bryan Andrew J, Sanders Thomas L, Selles Ruud W, Gelfman Russell, Amadio Peter C
机构信息
Mayo Clinic, Rochester, Minnesota, and Erasmus Medical Center, Rotterdam, The Netherlands.
Mayo Clinic, Rochester, Minnesota.
出版信息
Arthritis Care Res (Hoboken). 2017 Jul;69(7):1060-1065. doi: 10.1002/acr.23108. Epub 2017 Jun 8.
OBJECTIVE
To compare the effectiveness of ultrasound-guided injections to blind injections in the treatment of carpal tunnel syndrome (CTS) in a large community-based cohort.
METHODS
This study evaluated residents of Olmsted County, Minnesota, treated with a corticosteroid injection for CTS between 2001 and 2010. The proportion of patients receiving retreatment and the duration of retreatment-free survival between blind and ultrasound-guided injections were compared. Propensity score matching was used to control for confounding by indication.
RESULTS
In the matched data set consisting of 234 (of 600) hands treated with a blind injection and 87 (of 89) ultrasound-guided injection cases, ultrasound guidance was associated with a reduced hazard of retreatment (hazard ratio 0.59 [95% confidence interval (95% CI) 0.37-0.93]). In addition, ultrasound guidance was associated with 55% reduced odds of retreatment within 1 year compared to blind injections (adjusted odds ratio 0.45 [95% CI 0.24-0.83]).
CONCLUSION
This study indicates that ultrasound-guided injections are more effective in comparison to blind injections in the treatment of CTS.
目的
在一个大型社区队列中比较超声引导注射与盲目注射治疗腕管综合征（CTS）的有效性。
方法
本研究评估了2001年至2010年间明尼苏达州奥尔姆斯特德县接受皮质类固醇注射治疗CTS的居民。比较了盲目注射组和超声引导注射组患者接受再次治疗的比例以及无再次治疗生存时间。采用倾向评分匹配法控制指征混杂因素。
结果
在由600只手中接受盲目注射的234只手和89只手中接受超声引导注射的87只手组成的匹配数据集中，超声引导与再次治疗风险降低相关（风险比0.59[95%置信区间（95%CI）0.37 - 0.93]）。此外，与盲目注射相比，超声引导在1年内再次治疗的几率降低了55%（调整后的优势比0.45[95%CI 0.24 - 0.83]）。
结论
本研究表明，在治疗CTS方面，超声引导注射比盲目注射更有效。
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