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高能聚焦体外冲击波疗法缓解了杜普伊特伦挛缩症的疼痛:一系列 7 例手部病例。

High-energy focused extracorporeal shockwave therapy relieved pain in Dupuytren's disease: a series of seven hands.

机构信息

Physical Medicine and Rehabilitation Hospital, Ardiya, Kuwait -

Department of Medicine, Faculty of Medicine, Kuwait University, Jabriya, Kuwait.

出版信息

Eur J Phys Rehabil Med. 2019 Dec;55(6):862-864. doi: 10.23736/S1973-9087.18.05498-9. Epub 2018 Oct 29.

Abstract

BACKGROUND

Dupuytren's disease of the hand is characterized by progressive thickening and shortening of palmar fascia resulting in flexion deformities of the digits and hence limitation of hand function. The objective of this study was to evaluate the effectiveness of shock-wave therapy on patients with Dupuytren's disease of the hand.

CASE REPORT

A case series study observed a total of four patients with Dupuytren's disease of the hand. All 4 patients had diabetes. Three patients had bilateral hand involvement. Two patients had flexion deformity. High-energy focused extracorporeal shockwave therapy was applied using a Storz Duolith SD1 (2000 impulses, 3 Hz, 1.24 mJ/mm2) in 5 sessions with 7 days between. Outcome measured included pain score, tender score, hand grip, and nodule size from the Michigan Hand Outcome Questionnaire, JAMAR hand held dynamometer, and ultrasonography. Data was collected at the entry and conclusion of the study at 0 and 8 weeks.

CLINICAL REHABILITATION IMPACT

Significant statistical improvement was observed for pain score 8.7±0.5 vs. 2.0±0.9, P<0.001 and for tender score 8.5±0.5 vs. 2.5±0.9, P<0.009 after the therapy. Decrease in size of nodules with improvement of flexion deformity was observed in one patient who had multiple bilateral nodules. No adverse effects were noted. Extracorporeal shockwave therapy was beneficial in relieving symptoms in Dupuytren's disease of the hand.

摘要

背景

手部的杜普伊特伦挛缩症的特征是手掌筋膜进行性增厚和缩短,导致手指弯曲畸形,从而限制手部功能。本研究的目的是评估冲击波治疗对手部杜普伊特伦挛缩症患者的疗效。

病例报告

对 4 例手部杜普伊特伦挛缩症患者进行了病例系列研究。所有 4 例患者均患有糖尿病。3 例患者双手受累。2 例患者存在弯曲畸形。使用 Storz Duolith SD1(2000 次脉冲,3 Hz,1.24 mJ/mm2)进行高能聚焦体外冲击波治疗,共 5 次,每次间隔 7 天。使用密歇根手功能问卷、JAMAR 手持测力计和超声检查评估包括疼痛评分、压痛评分、手握力和结节大小等结果。数据在研究开始时和第 0 周和第 8 周结束时收集。

临床康复影响

治疗后疼痛评分从 8.7±0.5 降至 2.0±0.9(P<0.001),压痛评分从 8.5±0.5 降至 2.5±0.9(P<0.009),观察到显著统计学改善。一名患者有多发性双侧结节,其结节大小减小,弯曲畸形改善。未观察到不良反应。体外冲击波治疗对手部杜普伊特伦挛缩症的症状缓解有益。

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