超声引导足底筋膜炎治疗的临床价值
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摘要
目的评估实时超声可视化技术引导药物注射足底跖筋膜炎治疗的安全性及有效性。资料与方法选取2017年6-10月于内蒙古医科大学第二附属医院超声科实施药物注射治疗并获得随访的38例足底跖筋膜炎患者,比较治疗前与治疗后7 d以及1、3、6个月的跖腱膜厚度、视觉模拟疼痛评分(VAS)、生活质量测量评分(QOL)及弹性变化。结果 38例患者均在超声可视化引导下顺利完成药物注射治疗,无明显并发症发生。治疗前与治疗后VAS、QOL评分比较,差异均有统计学意义(P<0.05)。治疗前与治疗后7 d、1个月跖腱膜厚度及弹性变化比较,差异均无统计学意义(P>0.05)。治疗后3个月、6个月比较,跖腱膜厚度及弹性变化差异有统计学意义(P<0.05)。结论实时超声可视化引导药物注射足底跖腱膜炎疗效明确、持久。
Purpose To evaluate the safety and efficacy of real-time ultrasound visualization technology in guiding medication injection for the treatment of plantar fasciitis. Materials and Methods A total of 38 patients with plantar fasciitis who had injection of medication in Department of Ultrasound, the Second Affiliated Hospital of Inner Mongolia Medical University from June to October 2017 and received follow-up visits were selected. Plantar fascia thickness, visual analog scale(VAS), quality of life(QOL) score, and elastic change 7 days, 1, 3 and 6 months after treatment was compared with those before treatment. Results Thirty-eight patients underwent successful medication injection under the guidance of ultrasound visualization, and no obvious complications occurred. The differences in VAS and QOL scores before and after treatment were statistically significant(P<0.05). The plantar fascia thickness and elasticity change 7 days and 1 month after treatment and that before treatment suggested no statistically significant difference(P>0.05). There showed statistically significant differences in plantar fascia thickness and elasticity change between those detected 3 months after treatment and 6 months after treatment(P<0.05). Conclusion Real-time ultrasound visualization guiding the injection of medication for treating plantar fasciitis produced clear, safe and long-lasting effects.
Purpose To evaluate the safety and efficacy of real-time ultrasound visualization technology in guiding medication injection for the treatment of plantar fasciitis. Materials and Methods A total of 38 patients with plantar fasciitis who had injection of medication in Department of Ultrasound, the Second Affiliated Hospital of Inner Mongolia Medical University from June to October 2017 and received follow-up visits were selected. Plantar fascia thickness, visual analog scale(VAS), quality of life(QOL) score, and elastic change 7 days, 1, 3 and 6 months after treatment was compared with those before treatment. Results Thirty-eight patients underwent successful medication injection under the guidance of ultrasound visualization, and no obvious complications occurred. The differences in VAS and QOL scores before and after treatment were statistically significant(P<0.05). The plantar fascia thickness and elasticity change 7 days and 1 month after treatment and that before treatment suggested no statistically significant difference(P>0.05). There showed statistically significant differences in plantar fascia thickness and elasticity change between those detected 3 months after treatment and 6 months after treatment(P<0.05). Conclusion Real-time ultrasound visualization guiding the injection of medication for treating plantar fasciitis produced clear, safe and long-lasting effects.
引文
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[15]Co S,Bhalla S,Rowan K,et al.Comparison of 2-and 3-dimensional shoulder ultrasound to magnetic resonance imaging in a community hospital for the detection of supraspinatus rotator cuff tears with improved worktime room efficiency.CAR,2012,63(3):170-176.
[16]李志强,崔立刚,江凌,等.超声引导下足底跖腱膜炎药物注射治疗的疗效评估.中国超声医学杂志,2017,33(9):829-831.
[17]贺凡丁,卢漫,成雪晴,等.超声引导下介入治疗跖筋膜炎的临床价值.中华医学超声杂志:电子版,2015,12(1):40-43.
[18]张隽,邓又斌,黄媛,等.探头扫查平面与肌纤维走行方向夹角对剪切波传播速度的影响.中国医学影像技术,2013,29(9):1497-1499.
[19]姜镔,王学梅,王云忠,等.实时剪切波弹性成像测量胸锁乳突肌杨氏模量时声束平面与肌束不同角度对测量值的影响.中国医学影像技术,2014,30(2):269-272.
[20]傅晓红,刘淼,沈燕,等.灰阶超声和超声弹性成像对比及联合诊断多发性肌炎﹑皮肌炎的探索.中国临床医学影像杂志,2011,22(7):518-520.
[21]牛旺,史铁梅,张原溪.实时剪切波弹性成像技术在骨骼肌中的应用进展.中国医学影像技术,2017,33(10):1583-1586.
[22]Sconfienza LM,Silvestri E,Orlandi D,et al.足底筋膜的实时超声弹性成像:足底筋膜炎病人与健康对照组比较.国际医学放射学杂志,2013,36(3):278-283.
[2]张建中,马可.足底筋膜炎的基础及临床研究.足踝外科电子杂志,2014,12(1):67-71.
[3]张鹏,俞光荣.足底跖腱膜炎的研究现状.中国矫形外科杂志,2013,21(23):2375-2378.
[4]Lou J,Wang S,Liu S,et al.Effectiveness of extracorporeal shock wave therapy without local anesthesia in patients with recalcitrant plantar fasciitis.Am J Phys Med Rehabil,2017,96(8):529-534.
[5]李志云,倪喆,邵增务.足底筋膜炎治疗的进展.中华物理医学与康复杂志,2012,34(9):702-704.
[6]Eslamian F,Shakouri SK,Jahanjoo FA,et al.Extra corporeal shock wave therapy versus local corticosteroid injection in the treatment of chronic plantar fasciitis,a single blinded randomized clinical trial.Pain Med,2016,17(9):1722-1731.
[7]梁婷婷,崔立刚,朱璐,等.超声在跖腱膜病变诊断中的应用价值.中国超声医学杂志,2015,31(11):1029-1031.
[8]宋烨,李园,陆雯,等.超声检查足底腱膜厚度和回声的信度研究.中华创伤骨科杂志,2014,16(6):486-489.
[9]Salvi AE.Targeting the plantar fascia for corticosteroid injection.J Foot Ankle Surg,2015,54(4):683-685.
[10]Karimzadeh A,Raeissadat SA,Fam SE,et al.Autologous whole blood versus corticosteroid local injection in treatment of plantar fasciitis:a randomized,controlled multicenter clinical trial.Clin Rheumatol,2017,36(3):661-669.
[11]Hocaoglu S,Vurdem UE,Cebicci MA,et al.Comparative effectiveness of radial extracorporeal shockwave therapy and Ultrasound-guided local corticosteroid injection treatment for plantar fasciitis.J Am Podiatr Med Assoc,2017,107(3):192-199.
[12]Lee HS,Choi YR,Kim SW,et al.Risk factors affecting chronic rupture of the plantar fascia.Foot Ankle Int,2014,35(3):258-263.
[13]Eslamian F,Shakouri SK,Jahanjoo FA,et al.Extra corporeal shock wave therapy versus local corticosteroid injection in the treatment of chronic plantar fasciitis,a single blinded randomized clinical trial.Pain Med,2016,17(9):1722-1731.
[14]Chen CM,Chen JS,Tsai WC,et al.Effectiveness of deviceassisted ultrasound-guided steroid injection for treating plantar fasciitis.Am J Phys Med Rehabil,2013,92(7):597-605.
[15]Co S,Bhalla S,Rowan K,et al.Comparison of 2-and 3-dimensional shoulder ultrasound to magnetic resonance imaging in a community hospital for the detection of supraspinatus rotator cuff tears with improved worktime room efficiency.CAR,2012,63(3):170-176.
[16]李志强,崔立刚,江凌,等.超声引导下足底跖腱膜炎药物注射治疗的疗效评估.中国超声医学杂志,2017,33(9):829-831.
[17]贺凡丁,卢漫,成雪晴,等.超声引导下介入治疗跖筋膜炎的临床价值.中华医学超声杂志:电子版,2015,12(1):40-43.
[18]张隽,邓又斌,黄媛,等.探头扫查平面与肌纤维走行方向夹角对剪切波传播速度的影响.中国医学影像技术,2013,29(9):1497-1499.
[19]姜镔,王学梅,王云忠,等.实时剪切波弹性成像测量胸锁乳突肌杨氏模量时声束平面与肌束不同角度对测量值的影响.中国医学影像技术,2014,30(2):269-272.
[20]傅晓红,刘淼,沈燕,等.灰阶超声和超声弹性成像对比及联合诊断多发性肌炎﹑皮肌炎的探索.中国临床医学影像杂志,2011,22(7):518-520.
[21]牛旺,史铁梅,张原溪.实时剪切波弹性成像技术在骨骼肌中的应用进展.中国医学影像技术,2017,33(10):1583-1586.
[22]Sconfienza LM,Silvestri E,Orlandi D,et al.足底筋膜的实时超声弹性成像:足底筋膜炎病人与健康对照组比较.国际医学放射学杂志,2013,36(3):278-283.