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经保守治疗无效的慢性肱骨内上髁炎患者行动脉内栓塞治疗的短期疗效:一项单中心回顾性队列研究。

Short-term Results of Transcatheter Arterial Embolization for Chronic Medial Epicondylitis Refractory to Conservative Treatment: A Single-Center Retrospective Cohort Study.

机构信息

Department of Radiology, Seoul National University Bundang Hospital, Bundang, Seongnam, Republic of Korea.

Department of Radiology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Republic of Korea.

出版信息

Cardiovasc Intervent Radiol. 2022 Feb;45(2):197-204. doi: 10.1007/s00270-021-02878-2. Epub 2021 Jun 4.

Abstract

PURPOSE

To evaluate the effectiveness and safety of transcatheter arterial embolization (TAE) for chronic medial epicondylitis (ME) refractory to conservative treatments.

MATERIALS AND METHODS

This retrospective study included ten patients (14 procedures) who underwent TAE between May of 2018 and April of 2020 to treat chronic ME refractory to conservative treatments for at least 3 months. Imipenem/cilastatin sodium was used in 12 procedures, and quick-soluble gelatin sponge particles were used in the ensuing two procedures as an embolic agent. The visual analogue scale (VAS, 0-10) score and Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) scores were assessed at baseline and at different post-treatment times (1 day; 1 week; 1, 3, and 6 months; and an open period). The clinical success of the procedure was defined as a decrease of more than 70% in the Quick-DASH scores at 6 months compared to the baseline.

RESULTS

Clinical success was achieved in 12 of 14 procedures (85.7%). No major complications were observed during the follow-up periods. The mean VAS scores were significantly decreased at 1 day, 1 week, 1 month, 3 months and 6 months (7.6 at baseline vs. 3.6, 3.6, 3.6, 3, and 0.9 after treatment; all P < .01). The mean Quick-DASH scores at baseline decreased significantly at 1 day, 1 week, and at 1, 3, and 6 months after treatment (71.9 vs. 48.5, 44, 37.7, 30.2, and 8.4; all P < .01). These improvements endured in nine patients for up to 12 months after treatment.

CONCLUSION

TAE effectively and safely relieved pain and promoted functional recovery in chronic ME patients refractory to conservative treatments. TAE may be a feasible treatment option for patients with ME intractable to conservative treatments.

摘要

目的

评估经导管动脉栓塞 (TAE) 治疗对保守治疗无效的慢性肱骨外上髁炎 (ME) 的有效性和安全性。

材料和方法

本回顾性研究纳入了 2018 年 5 月至 2020 年 4 月期间因保守治疗至少 3 个月无效而接受 TAE 治疗的 10 名患者(14 例)。12 例采用亚胺培南/西司他丁钠,随后 2 例采用可速溶明胶海绵颗粒作为栓塞剂。在基线和不同的治疗后时间(1 天;1 周;1、3 和 6 个月;开放期)评估视觉模拟量表(VAS,0-10)评分和快速上肢和手部残疾问卷(Quick-DASH)评分。将治疗后 6 个月 Quick-DASH 评分较基线下降超过 70%定义为手术成功。

结果

14 例中有 12 例(85.7%)手术成功。随访期间无重大并发症发生。治疗后 1 天、1 周、1 个月、3 个月和 6 个月 VAS 评分均显著降低(基线时 7.6 分,治疗后 3.6、3.6、3.6、3.0 和 0.9 分;均 P<0.01)。治疗后 1 天、1 周和 1、3 和 6 个月时 Quick-DASH 评分显著降低(基线时 71.9 分,治疗后 48.5、44、37.7、30.2 和 8.4 分;均 P<0.01)。9 例患者在治疗后 12 个月内疼痛缓解和功能恢复持续改善。

结论

TAE 有效且安全地缓解了对保守治疗无效的慢性 ME 患者的疼痛,并促进了其功能恢复。TAE 可能是对保守治疗无效的 ME 患者的一种可行治疗选择。

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