本文選題：聚焦超聲　切入點(diǎn)：慢性軟組織損傷　出處：《重慶醫(yī)科大學(xué)》2015年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的評(píng)估高強(qiáng)度聚焦超聲間斷治療慢性軟組織損傷性疼痛的有效性及安全性,并比較其與低強(qiáng)度聚焦超聲持續(xù)治療慢性軟組織損傷性疼痛的差異,擬指導(dǎo)臨床應(yīng)用。方法100名符合慢性軟組織損傷性疼痛診斷的患者,均給予相同的藥物治療,隨機(jī)分為L(zhǎng)G、HG兩組,每組50人。低強(qiáng)度聚焦超聲組(LG: Low focused ultrasound group):以患者于治療部位能感受到(酸、麻、脹、痛)的最小聚焦超聲強(qiáng)度,持續(xù)治療10min。高強(qiáng)度聚焦超聲組(HG: High focused ultrasound group):以患者可以耐受的最大聚焦超聲強(qiáng)度分次治療,每次治療1min,間歇lmin,共治療10次。觀察各組治療前后NRS評(píng)分、痛閾改變情況、生活質(zhì)量量表(SF-36)及抑郁量表(BDI)評(píng)分,并記錄不良反應(yīng)。結(jié)果1)兩組患者治療后NRS評(píng)分、BDI評(píng)分與治療前比較明顯降低(P0.05),治療部位及小腿脛前機(jī)械痛閾明顯增高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；2)SF-36量表8個(gè)維度評(píng)價(jià)中,軀體疼痛(BP)、精力(VT)、社會(huì)功能(SF)、精神健康(MH)4個(gè)維度及心理健康評(píng)分(MCS)兩組治療前后均有明顯差異(P0.05),而生理機(jī)能(PF)、生理職能(RP)、一般健康狀況(GH)、情感職能(RE)4個(gè)維度及生理健康總評(píng)(PCS)兩組治療前后變化均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3)組間比較,LG治療后NRS評(píng)分降低,與HG比較有統(tǒng)計(jì)學(xué)差異(P0.05)。SF-36評(píng)分8個(gè)維度中,BP、VT 2個(gè)維度評(píng)分增加與HG組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),但兩組治療后痛閾、BDI評(píng)分改變差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。4)LG、HG兩組不良反應(yīng)發(fā)生率分別為0%、8%,不良反應(yīng)發(fā)生率兩組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論高強(qiáng)度聚焦超聲間斷治療慢性軟組織損傷性疼痛有效；與高強(qiáng)度聚焦超聲間斷治療比較,以患者在治療部位能感受到(酸、麻、脹、痛)的最小聚焦超聲強(qiáng)度連續(xù)治療效果更好,副作用更小。
[Abstract]:Objective to evaluate the efficacy and safety of intermittent high-intensity focused ultrasound (HIFU) in the treatment of chronic soft tissue injury pain, and to compare the efficacy and safety of HIFU with low intensity focused ultrasound (LIFU) in the treatment of chronic soft tissue injury pain. Methods 100 patients who met the diagnosis of chronic soft tissue injury pain were treated with the same drug and were randomly divided into LGG group and LGHG group. Low intensity focused ultrasound (LIFU) group: Low focused ultrasound group: the minimum intensity of focused ultrasound (acid, anesthesia, distension, pain) was felt at the site of treatment. HG: High focused ultrasound group was treated with HG: High focused ultrasound group for 10 minutes. The patients were treated with the maximum intensity of focused ultrasound for 10 times. The NRS score and pain threshold were observed before and after treatment, and the changes of pain threshold were observed before and after the treatment. Results 1) after treatment, the scores of NRS score and BDI score were significantly lower than those before treatment, and the mechanical pain threshold of the treatment site and the leg before treatment were significantly higher than those before treatment, and the scores of SF-36) and depression scale were recorded in the two groups. 1) after treatment, the scores of NRS and BDI were significantly lower than those before treatment, and the mechanical pain threshold of the treatment site and the leg before treatment were significantly increased. The difference was statistically significant in 8 dimensions of SF-36 scale. There were significant differences between the two groups in the four dimensions of somatic pain, energy, social function, social function, mental health and mental health before and after treatment (P 0.05), while the physiological function of PFN, physiological function, general health status, emotional function and emotional function were 4 dimensions and 4 dimensions, respectively, and the birth of the two groups were all significant differences before and after the treatment (P0. 05%, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P < 0. 05). There was no significant difference between the two groups before and after treatment (P 0.05). 3) the NRS scores of the two groups were lower than those of the group treated with LG, and there was no significant difference between the two groups before and after treatment. There was statistical difference between HG and HG in the eight dimensions of P0.05 SF-36 score. There was a significant difference between HG group and HG group in the increase of BP5 VT score. However, there was no significant difference in BDI score between the two groups after treatment. There was no significant difference in the incidence of adverse reactions between the two groups. The birth rate was 0% and 8% respectively. The incidence of adverse reactions was compared between the two groups. Conclusion High intensity focused ultrasound is effective in the treatment of chronic soft tissue injury pain. The effect of continuous treatment with minimal focused ultrasound intensity was better and the side effect was less.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R614

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