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[桡骨茎突狭窄性腱鞘炎关节镜治疗临床效果的病例对照研究]

[Case control study on clinical effects of arthroscopic treatment for stenosing tenosynovitis of radial styloid process].

作者信息

Hong Jian-Fei, Bi Qing, Xia Bing, Zhang Shui-Jun, Qiu Bin-Song

机构信息

Department of Orthopaedics, People's Hospital of Zhejiang Province, Hangzhou 310014, Zhejiang, China;

Department of Orthopaedics, People's Hospital of Zhejiang Province, Hangzhou 310014, Zhejiang, China.

出版信息

Zhongguo Gu Shang. 2016 Sep 25;29(9):825-830. doi: 10.3969/j.issn.1003-0034.2016.09.011.

Abstract

OBJECTIVE

To investigate the clinical effect of arthroscopic treatment for stenosing tenosynovitis of radial styloid process.

METHODS

Ninety nine patients diagnosed as stenosing tenosynovitis of radial styloid process from August, 2009 to July, 2013 were divided into three groups, including arthroscopic treatment group(32 cases), traditional operation group (34 cases) and local blocking therapy group(33 cases). Ache, tenderness, swollen situations and movement degrees of wrist joints and thumbs were observed before treatment and one week and one month after treatment. Total effective rates were calculated.

RESULTS

Pain score of the wrist and thumb in activity state was lower in arthroscopic treatment group and traditional operation group than that in local blocking therapy group one week and one month after treatment(=0.044, 0.039). Local pain score was lower in arthroscopic treatment group and traditional operation group than that in local blocking therapy group one month after treatment(=0.017). The total symptom score was lower in arthroscopic treatment group and traditional operation group than that in local blocking therapy group one week and one month after treatment(=0.007, 0.015). The effective rates one week after treatment in arthroscopic treatment group, traditional operation group and local blocking therapy group were respectively 96.9%, 94.1% and 84.8%, without significant differences(=0.213). The effective rates one month after treatment in these three groups were respectively 93.8%, 97.1% and 72.7%, with significant differences(=0.006).

CONCLUSIONS

Compared with traditional operation and local blocking therapy, arthroscopic treatment has certain effects for the treatment of stenosing tenosynovitis of radial styloid process, with less operation trauma and complications, and it is worthy of clinical promotion.

摘要

目的

探讨关节镜治疗桡骨茎突狭窄性腱鞘炎的临床疗效。

方法

选取2009年8月至2013年7月诊断为桡骨茎突狭窄性腱鞘炎的99例患者,分为三组,即关节镜治疗组(32例)、传统手术组(34例)和局部封闭治疗组(33例)。观察治疗前及治疗后1周、1个月时患者的疼痛、压痛、肿胀情况以及腕关节和拇指的活动度,并计算总有效率。

结果

治疗后1周和1个月时,关节镜治疗组和传统手术组活动状态下腕关节和拇指的疼痛评分低于局部封闭治疗组(P = 0.044,0.039)。治疗后1个月时,关节镜治疗组和传统手术组的局部疼痛评分低于局部封闭治疗组(P = 0.017)。治疗后1周和1个月时,关节镜治疗组和传统手术组的总症状评分低于局部封闭治疗组(P = 0.007,0.015)。治疗后1周时,关节镜治疗组、传统手术组和局部封闭治疗组的有效率分别为96.9%、94.1%和84.8%,差异无统计学意义(P = 0.213)。治疗后1个月时,三组有效率分别为93.8%、97.1%和72.7%,差异有统计学意义(P = 0.006)。

结论

与传统手术和局部封闭治疗相比,关节镜治疗桡骨茎突狭窄性腱鞘炎有一定疗效,手术创伤小、并发症少,值得临床推广。

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