Lin Meng-Ting, Liu I-Chun, Syu Wei-Ting, Kuo Po-Ling, Wu Chueh-Hung
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 300, Taiwan.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 100, Taiwan.
Diagnostics (Basel). 2021 May 9;11(5):849. doi: 10.3390/diagnostics11050849.
This study aimed to investigate the effect of different injectate volumes on ultrasonographic parameters and the correlation to clinical outcomes under perineural dextrose injection (PDI). In this post hoc analysis of the randomized, double-blinded, three-arm trial, ultrasound-guided PDI with either 1 mL, 2 mL, and 4 mL 5% dextrose water was administered, respectively, in 14, 14, and 17 patients. Ultrasound outcomes included mobility, shear-wave elastography (SWE), and cross-sectional area (CSA) of the median nerve; clinical outcomes were Visual Analog Scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ) score. Outcomes were measured before injection, and after injection at the 1st, 4th, 12th, and 24th week. For ultrasound outcomes, CSA decreased significantly from baseline data at all follow-up time-points in the 2 mL group ( = 0.005) and the 4 mL group ( = 0.015). The mean change of mobility from baseline showed a greater improvement on the 4 mL group than the other groups at the 1st week post-injection. For clinical outcomes, negative correlation between the VAS and mobility at the 1st ( = 0.046) and 4th week ( = 0.031) post-injection in the 4 mL group were observed. In conclusion, PDI with higher volume yielded better nerve mobility and decreased CSA of median nerve, but no changes of nerve elasticity.
本研究旨在探讨在神经周围注射葡萄糖（PDI）时，不同注射体积对超声参数的影响以及与临床结局的相关性。在这项对随机、双盲、三臂试验的事后分析中，分别对14例、14例和17例患者进行了超声引导下的PDI，注射物分别为1 mL、2 mL和4 mL的5%葡萄糖水。超声检查结果包括正中神经的活动度、剪切波弹性成像（SWE）和横截面积（CSA）；临床结局指标为视觉模拟评分（VAS）和波士顿腕管综合征问卷（BCTQ）评分。在注射前以及注射后第1、4、12和24周测量各项指标。对于超声检查结果，2 mL组（P = 0.005）和4 mL组（P = 0.015）在所有随访时间点的CSA均较基线数据显著降低。注射后第1周，4 mL组的活动度较基线的平均变化比其他组有更大改善。对于临床结局，在4 mL组中观察到注射后第1周（P = 0.046）和第4周（P = 0.031）时VAS与活动度之间呈负相关。总之，较高体积的PDI可产生更好的神经活动度并降低正中神经的CSA，但神经弹性无变化。
