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三级医疗中心外侧上髁炎的诊断与管理模式

Diagnosis and Management Pattern of Lateral Epicondylitis in a Tertiary Care Center.

作者信息

Dhakal S, Acharya T, Gautam S, Upadhyay N, Dhakal S

机构信息

Department of Pharmacy, National Model College for Advanced Learning, Tribhuvan University, Nayabazar, Kathmandu, Nepal.

Department of Pharmacy, National Model College for Advanced Learning, Tribhuvan University, Nayabazar, Kathmandu, Nepal, Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal.

出版信息

JNMA J Nepal Med Assoc. 2015 Oct-Dec;53(200):231-234.

Abstract

INTRODUCTION

Lateral Epicondylitis has been found to be the second most frequently diagnosed musculoskeletal disorder. A wide range of symptomatic treatments are available such as use of anti-inflammatory analgesic drugs, steroids, physiotherapy. This study aims to know about the diagnosis, prescription pattern and current practice on management of tennis elbow in Nepal.

METHODS

This is a hospital based observational study carried out at Bir Hospital, Kathmandu, Nepal. Patients diagnosed with tennis elbow were purposively selected through prospective sampling technique from Orthopedic Department. Questionnaire and patient medication files were used as tools for data collection.

RESULTS

A total of 97 patients were found to be suffering from tennis elbow affecting mostly 41-50 years of age group and seen mostly in female (62%). Further, it was found that housewives (31%) were mostly affected. Diagnosis of tennis elbow was done commonly by clinical evaluation (61%) and X-ray (39%). Both Pharmacological and Non-Pharmacological approaches were in practice. Pharmacological treatment include NSAIDS (59% Aceclofenac, 19% Naproxen, 18% Indomethacin, 16% Diclofenac, 6% Piroxicam) and Steroids (23% methylprednisolone acetate and 21% oral prednisolone). Non-Pharmacological treatment was done by lifestyle modification (100%), 78% application of heat, 63% use of tennis elbow band, 29% exercise and 28% physiotherapy. Surgical intervention (3%) was also done when the conservative management failed.

CONCLUSION

There is professional risk of tennis elbow for housewives, farmers and shopkeepers in context of Nepal. Only one treatment approach is not effective in management of tennis elbow for long term effect.

摘要

引言

肱骨外上髁炎是第二常见的肌肉骨骼疾病。目前有多种对症治疗方法,如使用抗炎镇痛药、类固醇和物理治疗。本研究旨在了解尼泊尔网球肘的诊断、处方模式及当前治疗方法。

方法

这是一项在尼泊尔加德满都比尔医院开展的基于医院的观察性研究。通过前瞻性抽样技术从骨科有目的地选取被诊断为网球肘的患者。问卷和患者用药档案用作数据收集工具。

结果

共发现97例网球肘患者,主要集中在41 - 50岁年龄组,女性居多(62%)。此外,发现家庭主妇受影响最大(31%)。网球肘的诊断通常通过临床评估(61%)和X线检查(39%)。药物治疗和非药物治疗方法均有应用。药物治疗包括非甾体抗炎药(59%使用醋氯芬酸、19%使用萘普生、18%使用吲哚美辛、16%使用双氯芬酸、6%使用吡罗昔康)和类固醇(23%使用醋酸甲泼尼龙、21%使用口服泼尼松龙)。非药物治疗包括生活方式改变(100%)、热敷(78%)、使用网球肘护具(63%)、锻炼(29%)和物理治疗(28%)。保守治疗无效时也会进行手术干预(3%)。

结论

在尼泊尔,家庭主妇、农民和店主面临患网球肘的职业风险。单一治疗方法对网球肘的长期治疗效果不佳。

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