超声波联合联苯乙酸凝胶治疗创伤性骨化性肌炎的临床效果
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摘要
目的评估超声波联合联苯乙酸凝胶治疗创伤后骨化性肌炎的临床效果,旨在探讨骨化性肌炎康复的有效方法。方法回顾性分析2015年9～2017年9月在西安交通大学附属红会医院诊治骨化性肌炎的32例患者(试验组)和同期16例无骨化性肌炎患者(对照组)的临床资料。通过超声波联合联苯乙酸凝胶渗透的方法,观察X线表现与临床症状、碱性磷酸酶、疼痛评分、关节活动度与功能及患者满意度。结果超声波联合联苯乙酸凝胶治疗后患者的临床症状与X线表现好转,碱性磷酸酶在治疗后1个月明显降低,治疗后疼痛评分降低(P<0.05);治疗后肘、膝关节活动度与关节功能评分均优于治疗前,患者满意度提高(P<0.05)。结论超声波联合联苯乙酸凝胶能有效促进创伤后骨化性肌炎患者的关节功能康复并减轻疼痛,是一种安全、有效、无副作用的康复手段,值得推广。
Objective To evaluate the clinical efficacy of combining ultrasound with Felbinac Gel in myositis ossificans traumatica, and to explore the effective rehabilitation approaches of myositis ossificans. Methods Clinical data of 32 patients with myositis ossification(experimental group) and 16 patients with non-myositis ossification during the same period(control group) in Honghui Hospital, Xi′ an Jiaotong University from September 2015 to September 2017 were retrospectively analyzed. The X-ray and clinical symptoms, alkaline phosphatase, pain scores, joint activity and patient satisfaction were observed respectively by way of combining ultrasound with Felbinac Gel penetration method. Results After the treatment of ultrasound combined with Felbinac Gel, the clinical symptoms and X-ray of patients were improved, and alkaline phosphatase was reduced significantly 1 month after treatment, as well as the pain scores(P <0.05). Meanwhile, the joint activity and joint function scores were superior to those of pre-therapy, and patients′ satisfaction was improved(P < 0.05). Conclusion The method of ultrasound combined with Felbinac Gel can effectively promote the recovery of joint function and relieve pain of patients with myositis ossificans traumatica. The rehabilitation approach is safe, effective and without side effect. It is worthy of wide application.
Objective To evaluate the clinical efficacy of combining ultrasound with Felbinac Gel in myositis ossificans traumatica, and to explore the effective rehabilitation approaches of myositis ossificans. Methods Clinical data of 32 patients with myositis ossification(experimental group) and 16 patients with non-myositis ossification during the same period(control group) in Honghui Hospital, Xi′ an Jiaotong University from September 2015 to September 2017 were retrospectively analyzed. The X-ray and clinical symptoms, alkaline phosphatase, pain scores, joint activity and patient satisfaction were observed respectively by way of combining ultrasound with Felbinac Gel penetration method. Results After the treatment of ultrasound combined with Felbinac Gel, the clinical symptoms and X-ray of patients were improved, and alkaline phosphatase was reduced significantly 1 month after treatment, as well as the pain scores(P <0.05). Meanwhile, the joint activity and joint function scores were superior to those of pre-therapy, and patients′ satisfaction was improved(P < 0.05). Conclusion The method of ultrasound combined with Felbinac Gel can effectively promote the recovery of joint function and relieve pain of patients with myositis ossificans traumatica. The rehabilitation approach is safe, effective and without side effect. It is worthy of wide application.
引文
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[17]Walczak BE,Johnson CN,Howe BM.Myositis Ossificans[J].J Am Acad Orthop Surg,2015,23(10):612-622.
[18]Hatsell SJ.ACVR1R206H receptor mutation causes fibrodysplasia ossificans progressiva by imparting responsiveness to activin A[J].Sci Transl Med,2015,7:303ra137.
[19]Katagiri T.A Door Opens for Fibrodysplasia Ossificans Progressiva[J].Trends Biochem Sci,2016,41(2):119-121.
[20]刘晓冬.非甾体类药预防性治疗肘部外伤术后并发骨化性肌炎[J].创伤外科杂志,2011,13(4):322-323.
[21]Fijn R,Koorevaar RT,Brouwers JR.Prevention of heterotopic ossification after total hip replacement with NSAIDs[J].Pharm World Sci,2003,25(4):138-145.
[22]Rath E,Warschawski Y,Maman E,et al.Selective COX-2 Inhibitors Significantly Reduce the Occurrence of Heterotopic Ossification After Hip Arthroscopic Surgery[J].Am J Sports Med,2016,44(3):677-681.
[23]Bagnulo A,Gringmuth R.Treatment of Myositis Ossificans with acetic acid phonophoresis:a case series[J].J Can Chiropr Assoc,2014,58(4):353-360.
[24]徐小梅.醋酸泼尼松龙注射液超声透入治疗骨化性肌炎1例[J].中国疗养医学,2005,14(5):359.
[2]Simon T,Guillodo Y,Madouas G,et al.Myositis ossificans traumatica(circumscripta)and return to sport:A retrospective series of 19 cases[J].Joint Bone Spine,2016,83(4):416-420.
[3]Kanthimathi B,Udhaya Shankar S,Arun Kumar K,et al.Myositis ossificans traumatica causing ankylosis of the elbow[J].Clin Orthop Surg,2014,6(4):480-483.
[4]Muir B.Myositis ossificans traumatica of the deltoid ligament in a 34 year old recreational ice hockey player with a 15 year post-trauma follow-up:a case report and review of the literature[J].J Can Chiropr Assoc,2010,54(4):229-242.
[5]Wilkes LL.Myositis ossificans traumatica in a young child:a case report[J].Clin Orthop Relat Res,1976,118:151-152.
[6]Parikh J,Hyare H,Saifuddin A.The imaging features of posttraumatic myositis ossificans,with emphasis on MRI[J].Clin Radiol,2002,57(12):1058-1066.
[7]Beiner JM,Jokl P.Muscle contusion injury and myositis ossificans traumatica[J].Clin Orthop,2002,403S:S110-S119.
[8]Demir MK,Beser M,Akinei O.Case 118:Proliferative myositis[J].Radiology,2007,244(2):613-616.
[9]Bourdel N,Alves J,Pickering G,et al.Systematic review of endometriosis pain assessment:how to choose a scale?[J].Human Reproduction Update,2014,21(1):136-152.
[10]Sinha S,Schreiner AJ,Biernaskie J,et al.Treating pain on skin graft donor sites:review and clinical recommendations[J].J Trauma Acute Care Surg,2017,83(5):954-964.
[11]Modabber MR,Jupiter JB.Reconstruction for post traumatic condition of the elbow joint[J].J Bone Joint Sury Am,1995,77(9):1431-1446.
[12]杜路,孙银娣.肘关节骨化性肌炎的蜡疗观察[J].美中国际创伤杂志,2010,9(2):22-23.
[13]蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2005.
[14]陈罗西,刘波,张晓芳,等.传统关节黏连松解术联合中药内服外敷治疗骨化性肌炎并发关节僵硬[J].中医正骨,2017,29(4):76-78.
[15]Gozo MC1,Aspuria PJ,Cheon DJ,et al.Foxc2 induces Wnt4and Bmp4 expression during muscle regeneration and osteogenesis[J].Cell Death Differ,2013,20(8):1031-1042.
[16]Yu PB,Deng DY,Lai CS,et al.BMP type I receptor inhibition reduces heterotopic[corrected]ossification[J].Nat Med,2008,14(12):1363-1369.
[17]Walczak BE,Johnson CN,Howe BM.Myositis Ossificans[J].J Am Acad Orthop Surg,2015,23(10):612-622.
[18]Hatsell SJ.ACVR1R206H receptor mutation causes fibrodysplasia ossificans progressiva by imparting responsiveness to activin A[J].Sci Transl Med,2015,7:303ra137.
[19]Katagiri T.A Door Opens for Fibrodysplasia Ossificans Progressiva[J].Trends Biochem Sci,2016,41(2):119-121.
[20]刘晓冬.非甾体类药预防性治疗肘部外伤术后并发骨化性肌炎[J].创伤外科杂志,2011,13(4):322-323.
[21]Fijn R,Koorevaar RT,Brouwers JR.Prevention of heterotopic ossification after total hip replacement with NSAIDs[J].Pharm World Sci,2003,25(4):138-145.
[22]Rath E,Warschawski Y,Maman E,et al.Selective COX-2 Inhibitors Significantly Reduce the Occurrence of Heterotopic Ossification After Hip Arthroscopic Surgery[J].Am J Sports Med,2016,44(3):677-681.
[23]Bagnulo A,Gringmuth R.Treatment of Myositis Ossificans with acetic acid phonophoresis:a case series[J].J Can Chiropr Assoc,2014,58(4):353-360.
[24]徐小梅.醋酸泼尼松龙注射液超声透入治疗骨化性肌炎1例[J].中国疗养医学,2005,14(5):359.