【摘要】：目的:1.研究放射式?jīng)_擊波治療對(duì)肱二頭肌長(zhǎng)頭腱鞘炎的臨床療效;2.研究肌骨超聲介入下復(fù)方倍他米松注射治療對(duì)肱二頭肌長(zhǎng)頭腱鞘炎的臨床療效;3.研究肌骨超聲介入下復(fù)方倍他米松注射治療與放射式?jīng)_擊波治療對(duì)肱二頭肌長(zhǎng)頭腱鞘炎的臨床療效。方法:回顧性收集2014年12月至2016年11月山西醫(yī)科大學(xué)附屬大醫(yī)院收治的72例經(jīng)核磁共振成像(MRI)檢查及查體均確診為肱二頭肌腱長(zhǎng)頭腱鞘炎的患者,根據(jù)不同治療方法分為肌骨超聲介入下復(fù)方倍他米松注射治療(超聲介入組,n=42)及放射式?jīng)_擊波治療(沖擊波治療組,n=30),分別于治療前,治療后即刻、1周、2周及5周評(píng)定患側(cè)肩的VAS評(píng)分、肩關(guān)節(jié)主動(dòng)前屈活動(dòng)度(AFROM)及肱二頭肌抗阻力試驗(yàn)(Speed試驗(yàn))。結(jié)果:超聲介入組患側(cè)肩的VAS評(píng)分于治療后各個(gè)時(shí)點(diǎn)與沖擊波治療組比較,均有所下降,超聲介入組下降速度快且幅度大,尤其是治療后即刻VAS評(píng)分下降最為明顯,兩組相比較差異有統(tǒng)計(jì)學(xué)意義(F=84.880,P0.01);超聲介入組肩的AFROM于治療后各個(gè)時(shí)點(diǎn)與沖擊波治療組所比較,活動(dòng)度所增加,尤其在治療后即刻、治療后1周的AFROM增加最明顯,兩組相比較差異有統(tǒng)計(jì)學(xué)意義(F=176.080,P0.01);超聲介入組的Speed試驗(yàn)于治療后1周、2周與沖擊波治療組相比較,陽(yáng)性率均有所下降,兩組相比較差異具有統(tǒng)計(jì)學(xué)意義(χ2=64.286,χ2=60.182,P0.01)。結(jié)論:1.放射式?jīng)_擊波治療可以改善肱二頭肌長(zhǎng)頭腱鞘炎局部疼痛及患者肩關(guān)節(jié)功能;2.肌骨超聲介入下復(fù)方倍他米松精準(zhǔn)注射治療可快速、明顯緩解肱二頭肌長(zhǎng)頭腱鞘炎患者的肩痛,增加肩關(guān)節(jié)前屈活動(dòng)度,提高肩關(guān)節(jié)功能,治療作用持續(xù)且不易反復(fù);3.肌骨超聲介入下1次精準(zhǔn)注射治療較放射式?jīng)_擊波5次治療肱二頭長(zhǎng)頭肌腱炎療效顯著,且經(jīng)濟(jì)價(jià)廉、明顯縮短病程。
[Abstract]:Purpose 1. To study the clinical effect of radiation shock wave therapy on long head tenosynovitis of biceps brachii muscle. To study the clinical curative effect of compound betamethasone injection in the treatment of long head tenosynovitis of biceps brachii muscle. To study the clinical effect of compound betamethasone injection and radiation shock wave on long head tenosynovitis of biceps brachii muscle. Methods: from December 2014 to November 2016, 72 patients with long head tenosynovitis of biceps tendon were diagnosed by (MRI) and physical examination of Shanxi Medical University. According to the different treatment methods, the patients were divided into two groups: compound betamethasone injection therapy (ultrasound intervention group) and radiation shock wave therapy (shock wave treatment group: 30%). The VAS score of the affected shoulder, the active anterior flexion range (AFROM) and the anti resistance test of biceps brachii muscle (Speed test) were evaluated immediately after 1 week, 2 weeks and 5 weeks after treatment. Results: the VAS score of the affected shoulder in the ultrasound intervention group was lower than that in the shock wave treatment group at all time points after treatment. The ultrasonic intervention group had a fast and large decline rate, especially the VAS score decreased most obviously immediately after treatment. There was a significant difference between the two groups (FF84.880, P0.01), the AFROM of the shoulder in the ultrasound intervention group increased at each time point after treatment compared with that in the shock wave treatment group, especially immediately after treatment, the AFROM increased most obviously at 1 week after treatment. There was significant difference between the two groups (FF176.080, P0.01), and the positive rate of Speed test in the ultrasound intervention group was lower than that in the shock wave group at 1 week and 2 weeks after treatment, and the difference between the two groups was statistically significant (蠂 2 + 64.286, 蠂 2 + 60.182% P 0.01). Conclusion 1. Radiation shock wave therapy can improve local pain and shoulder function of patients with long head tenosynovitis of biceps brachii muscle. The precise injection of compound betamethasone under the intervention of musculoskeletal ultrasound can relieve the shoulder pain of patients with long head tenosynovitis of biceps brachii, increase the range of shoulder flexion, improve the function of shoulder joint, and the therapeutic effect is continuous and difficult to repeat. The treatment of single precise injection with ultrasound was more effective than that of radiation shock wave 5 times in the treatment of long head tendinitis of long head of brachium, and it was economical and cheap, and shortened the course of disease obviously.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R686

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本文編號(hào)：2201982