局封结合针刀松解治疗拇指狭窄性腱鞘炎37例临床观察.docVIP

局封结合针刀松解治疗拇指狭窄性腱鞘炎37例临床观察摘 要 目的：总结、分析局封结合针刀在治疗拇指屈肌腱狭窄性腱鞘炎中的应用和临床效果并探讨手术技术。方法：2008年9月-2011年7月本中心诊治的拇指狭窄性腱鞘炎73例，采用数字表法分为治疗组(37例)和对照组(36例)，治疗组采用局封结合针刀松解治疗，对照组仅进行局封治疗，比较两者疗效。结果：治疗组临床治愈率为91.9%，对照组为33.3%，两组统计分析有显著性差异（P0.01）。结论：局封结合针刀治疗拇指狭窄性腱鞘炎创伤小，治愈率高，疗效更好，是治疗手指屈肌腱狭窄性腱鞘炎的一种理想方法，值得进行临床推广。 关键词 局封 针刀 拇指狭窄性腱鞘炎 中图分类号：R686 文献标识码：A 文章编号：1006-1533（2012）16-0026-03 Clinical observation on the local block anesthesia with accupotome releasing for treatment of 37 cases of thumb stenosis tenosynovitis ZHU Jing1, PENG Lei2 （1.Xicen Branch of Jinze Community Health Service Center，Qing-pu District，Shanghai，201721；2. Shangta Branch of Jinze Community Health Service Center，Qing-pu District，Shanghai，201721） ABSTRACT Objective: To summarize and analyze the application and clinical effect of local block anesthesia with accupotome in treatment of thumb stenosis tenosynovitis and probe into the method of operation. Method: Seventy three cases of thumb stenosis tenosynovitis who were diagnosed and treated in our centre from August 2008 to July 2011 were classified into treatment group(37 cases) and control group (36 cases) with the number table method. The treatment group was treated with accupotome and local block anesthesia and the control group was only treated with local block anesthesia then to judge their effects. Results: The curative rate was 91.9% in the treatment group and 33.3% in the control group, whose statistical analysis had obvious difference(P0.001). Conclusion: The treatment of thumb stenosis tensynvitis with accupotome and local block anesthesia has a small trauma, high curative and better effectiveness. It is an ideal treatment method and is worthy of clinical promotion. KEY WORDS local block anesthesia；accupotome；thumb stenosis tenosynovitis 屈指肌腱狭窄性腱鞘炎为骨科常见病，以拇指多发，手工劳动者尤其女性多见。主要致病原因是拇指屈肌腱和腱鞘频繁摩擦所致。主要表现为拇指掌指关节掌侧疼痛、硬结，屈伸活动受限或伴有弹响。本科室自2008年9月-2011年7月采用局封结合针刀闭合松解治疗拇指狭窄性腱鞘炎，为探讨该方法的效果，我们进行了对照实验。 1 对象与方法 1.1 对象 2008年9月-2011年7月本中心门诊治疗的拇指狭窄性腱鞘炎患者73例，所有对象均符合《中医