黄雯松 毛泽江 王将勇 吴光明 万少年

【摘要】 目的：探討针刀镜下腱鞘松解术治疗指屈肌腱狭窄性腱鞘炎（FTST）的临床效果。方法：选取2019年1月-2020年4月本院收治的60例FTST患者，按照随机数字表法将其分为对照组和治疗组，每组30例。对照组采用传统手术方法治疗，治疗组采用针刀镜下腱鞘松解术治疗。比较两组术前、术后即刻和术后3、6个月的手指功能分级（Quinnell分级）、疼痛程度及掌指关节处弹响、绞索、硬结情况，比较两组并发症发生情况及临床疗效。结果：术前，两组Quinnell分级比较，差异无统计学意义（P>0.05）;术后即刻和术后3、6个月，治疗组Quinnell分级均优于对照组，差异均有统计学意义（P<0.05）。术前，两组VAS评分比较，差异无统计学意义（P>0.05）;术后即刻和术后3、6个月，两组VAS评分均低于术前，且治疗组均低于对照组，差异均有统计学意义（P<0.05）。术前，两组掌指关节处弹响、绞索、硬结发生率比较，差异均无统计学意义（P>0.05），术后即刻和术后3、6个月，治疗组掌指关节处弹响、绞索、硬结发生率均低于对照组，差异均有统计学意义（P<0.05）。治疗组并发症发生率低于对照组，总有效率高于对照组，差异均有统计学意义（P<0.05）。结论：针刀镜下腱鞘松解术可有效改善患者临床症状，缓解患者疼痛，降低术后并发症发生率，有较好治疗效果，值得推广。

【关键词】 指屈肌腱狭窄性腱鞘炎 针刀镜 腱鞘松解术

Clinical Study on Release of Tendon Sheath under Acupotomy Mirror in the Treatment of Flexor Tendon Stenosing Tenosynovitis/HUANG Wensong， MAO Zejiang， WANG Jiangyong， WU Guangming， WAN Shaonian. //Medical Innovation of China， 2021， 18（28）： 113-117

[Abstract] Objective： To explore the clinical efficacy of release of tendon sheath under acupotomy mirror in the treatment of flexor tendon stenosing tenosynovitis （FTST）. Method： A total of 60 FTST patients admitted to our hospital from January 2019 to April 2020 were selected， and they were divided into control group and treatment group according to random number table method， 30 cases in each group. The control group was treated with traditional surgery， and the treatment group was treated with release of tendon sheath under acupotomy mirror. The finger function classification （Quinnell grade）， pain degree， snapping， strangulation， induration in the metacarpophalangeal joint before surgery， immediately after surgery and 3， 6 months after surgery were compared between two groups， and the incidence of complications and clinical efficacy were compared between two groups. Result： Before surgery， there was no significant difference in Quinnell grading between two groups （P>0.05）; immediately after surgery and 3， 6 months after surgery， the Quinnell grade of the treatment group were better than those of the control group， the differences were statistically significant （P<0.05）. Before surgery， there was no significant difference in VAS scores between two groups （P>0.05）; immediately after surgery and 3， 6 months after surgery， the VAS scores of both groups were lower than those before surgery， and those of the treatment group were lower than those of the control group， the differences were statistically significant （P<0.05）. Before surgery， there were no significant differences in the incidence of snapping， strangulation， induration in the metacarpophalangeal joint between two groups （P>0.05）; immediately after surgery and 3， 6 months after surgery， the incidence of snapping， strangulation， induration in the metacarpophalangeal joint of the treatment group were lower than those of the control group， the differences were statistically significant （P<0.05）. The incidence of complications of the treatment group was lower than that of the control group， and the total effective rate of the treatment group was higher than that of the control group， the differences were statistically significant （P<0.05）. Conclusion： Release of tendon sheath under acupotomy mirror can improve the clinical symptoms， relieve pain of patients and reduce the incidence of postoperative complications effectively， the treatment effect is good， it is worthy of promotion.

[Key words] Flexor tendon stenosing tenosynovitis Acupotomy mirror Release of tendon sheath

First-author’s address： Fuzhou Traditional Chinese Medicine Hospital， Fuzhou 344000， China

doi：10.3969/j.issn.1674-4985.2021.28.028

指屈肌腱狭窄性腱鞘炎（flexor tendon stenosing tenosynovitis，FTST）患者易出现指关节酸胀、疼痛、肿胀等症状，若不及时治疗，随着疾病进展还会导致弹响、绞索、屈伸功能障碍等，不利于患者身心健康[1-2]。……