细银质针导热松解术治疗肱二头肌长头腱炎的有效性和安全性的临床观察

EFFICACY AND SAFETY OF THIN SILVER NEEDLE HEAT CONDUCTION IN THE TREATMENT OF MYOTENOSITIS OF LONG HEAD OF BICEPS BRACHII

摘要:

摘要：目的：观察细银质针导热松解术治疗肱二头肌长头腱炎（Myotenositis of long head of biceps brachii，MLHB）的有效性和安全性。方法：纳入MLHB患者共102例，随机均分为细银质针导热组（A组）和局部注射组（B组），分别行细银质针导热松解术和局部药物注射，比较两组患者治疗前、治疗后5min、1周、2周及4周的肩关节功能评分（American shoulder and elbow surgeons’ form，ASES）、腱鞘积液厚度和长头腱周长，观察治疗及随访期间的并发症。结果：两组患者治疗前肩关节ASES、腱鞘积液厚度和长头腱周长无明显差异（P＞0.05）。A组治疗后1周时的ASES评分、腱鞘积液厚度较治疗前明显降低（P<0.001），治疗后4周时长头腱周长较治疗前明显减小（P<0.001）；B组治疗后5min时的ASES评分较治疗前明显升高（P<0.001），治疗后4周时较治疗后2周时的ASES评分明显降低（P<0.001）；治疗后2周腱鞘积液厚度较治疗前明显减少（P<0.001），治疗后1周长头腱周长较治疗前明显减少（P<0.001）。治疗4周后，细银质针组患者的ASES评分以及腱鞘积液厚度均优于局部封闭治疗组（P<0.001）。治疗及随访过程中，两组患者无明显不良反应。结论：细银质针导热松解术及局部药物注射均能改善MLHB的临床症状，细银质针导热松解术远期疗效优于局部药物注射治疗。

Abstract:

Abstract Objective：To evaluate the efficacy and safety of thin silver needle heat conduction in the treatment of myotenositis of the long head of biceps brachii (MLHB). Methods: 102 patients with MLHB were randomly and equally allocated to thin silver needle heat conduction group (group A) and local injection group (group B), and received thin silver needle heat conduction therapy and local injection respectively. American shoulder and elbow surgeons' form score (ASES), the thickness of tendon sheath effusion and the circumference of long head tendon were assessed and compared between both groups at pre-treatment, one week, two weeks and four weeks after treatment. Adverse reactions were also observed. Results: There was no significant difference between both groups in the ASES, the thickness tendon sheath effusion and the circumference of long head tendon before treatment (P > 0.05). In group A, the ASES score and the thickness of tendon sheath effusion were significantly reduced one week after treatment compared with that before treatment (P<0.001), and the long head tendon circumference was significantly reduced compared with that before treatment at four weeks after treatment (P<0.001). In group B, the ASES score was improved considerably five minutes after treatment (P<0.001), and was obviously lower four weeks after treatment than that on two weeks after treatment (P<0.001); The thickness of tendon sheath effusion was significantly reduced two weeks after treatment (P<0.001), and the head tendon circumference was significantly reduced one week after treatment (P<0.001). After four week treatment, both the ASES score and the thickness of tendon sheath effusion in group A were better than those in group B (P<0.001). There were no adverse events reported in both groups during the treatment and follow-up. Conclusion: Both thin silver needle heat conduction and local injection can alleviate the clinical symptoms of MLHB, but the long-term effect of thin silver needle heat conduction is better than that of local injection.