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皮质类固醇注射治疗扳机指后复发风险增加的相关因素。

Factors Associated with Increased Risk of Recurrence following Treatment of Trigger Finger with Corticosteroid Injection.

作者信息

Flensted Frederik, Jensen Claus Hjorth, Daugaard Henrik, Vedel Jens-Christian, Jørgensen Rasmus Wejnold

机构信息

Department of Orthopedics, Hand Clinic, Herlev-Gentofte University Hospital of Copenhagen, Copenhagen, Denmark.

Department of Orthopedics, Herlev-Gentofte University Hospital of Copenhagen, Copenhagen, Denmark.

出版信息

J Hand Microsurg. 2021 Apr;13(2):109-113. doi: 10.1055/s-0040-1719228. Epub 2020 Oct 29.

DOI:10.1055/s-0040-1719228
PMID:33867770
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8041498/
Abstract

The aim of the study was to estimate recurrence rates, time to recurrence, and predisposing factors for recurrence of trigger finger when treated with corticosteroid (CS) injection as primary treatment.  In a retrospective chart review, we identified primary trigger fingers treated with CS injection as primary treatment. Affected hand and finger, recurrence, time to recurrence, duration of symptoms, secondary treatment type, and comorbidities were recorded. A total of 539 patients were included with a mean follow-up of 47.6 months  In total, 330/539 (61%) recurrences were registered. Mean time to recurrence was 312 days. Increased risk of recurrence was seen after treatment of the third finger (relative risk [RR]: 1.22; 95% confidence interval [CI]: 1.06-1.39). Several comorbidities were associated with increased risk of recurrence: carpal tunnel syndrome (RR: 1.27; 95% CI: 1.07-1.52), thyroid disease (RR: 1.45; 95% CI: 1.15-1.83), or shoulder diseases (RR: 1.58; 95% CI: 1.36-1.83).  We found a recurrence rate after primary treatment of CS injection for trigger finger of 61%. Most recurrences happened within 2 years and we found treatment of third finger, carpal tunnel syndrome, shoulder, or thyroid disease to be associated with an increased risk of recurrence of symptoms.

摘要

本研究的目的是评估以皮质类固醇(CS)注射作为主要治疗方法时扳机指的复发率、复发时间和复发的诱发因素。

在一项回顾性病历审查中,我们确定了以CS注射作为主要治疗方法的原发性扳机指。记录受影响的手和手指、复发情况、复发时间、症状持续时间、二次治疗类型和合并症。共纳入539例患者,平均随访47.6个月。

总共记录到330/539例(61%)复发。平均复发时间为312天。治疗第三指后复发风险增加(相对风险[RR]:1.22;95%置信区间[CI]:1.06 - 1.39)。几种合并症与复发风险增加相关:腕管综合征(RR:1.27;95%CI:1.07 - 1.52)、甲状腺疾病(RR:1.45;95%CI:1.15 - 1.83)或肩部疾病(RR:1.58;95%CI:1.36 - 1.83)。

我们发现,以CS注射作为主要治疗方法治疗扳机指后的复发率为61%。大多数复发发生在2年内,并且我们发现治疗第三指、腕管综合征、肩部或甲状腺疾病与症状复发风险增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbbe/8041498/40f52ff31e57/10-1055-s-0040-1719228_00067_01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbbe/8041498/40f52ff31e57/10-1055-s-0040-1719228_00067_01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbbe/8041498/40f52ff31e57/10-1055-s-0040-1719228_00067_01.jpg

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本文引用的文献

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[Blind corticosteroid injection as primary treatment of trigger finger].[盲法皮质类固醇注射作为扳机指的主要治疗方法]
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Relationship of Carpal Tunnel Release and New Onset Trigger Finger.腕管松解术与新发扳机指的关系
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Efficacy of Corticosteroid Injection for Treatment of Trigger Finger: A Meta-Analysis of Randomized Controlled Trials.皮质类固醇注射治疗扳机指的疗效:随机对照试验的荟萃分析
J Invest Surg. 2019 Aug;32(5):433-441. doi: 10.1080/08941939.2018.1424970. Epub 2018 Jan 30.
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Coincidence or complication? A systematic review of trigger digit after carpal tunnel release.巧合还是并发症?腕管松解术后扳机指的系统评价
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Long-Term Effectiveness of Repeat Corticosteroid Injections for Trigger Finger.重复皮质类固醇注射治疗扳机指的长期疗效
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