| 徐华军,陈士芳,张惠美.超声引导下局部注射治疗类风湿性关节炎手腕部腱鞘炎[J].中国医学影像技术,2019,35(8):1123~1127 |
| 超声引导下局部注射治疗类风湿性关节炎手腕部腱鞘炎 |
| Ultrasound-guided local injection in treatment of hand and wrist tenosynovitis in patients with rheumatoid arthritis |
| 投稿时间：2019-03-27 修订日期：2019-07-03 |
| DOI：10.13929/j.1003-3289.201903206 |
| 中文关键词: 关节炎,类风湿 腱鞘炎 超声检查 鞘内注射 |
| 英文关键词:arthritis,rheumatoid tenosynovitis ultrasonography intrathecal injection |
| 基金项目:浙江省湖州市公益性应用研究项目（2017GYB25）。 |
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| 中文摘要: |
| 目的 探讨超声引导下局部注射治疗类风湿性关节炎（RA）手腕部腱鞘炎的临床效果。方法 对62例RA手腕部腱鞘炎患者分别给予超声引导下（超声引导组，n=37）及触诊引导下（触诊引导组，n=25）手腕部腱鞘注射复方倍他米松注射液和盐酸利多卡因注射液。对比分析2组治疗过程中不良反应发生率；比较2组治疗前及治疗后2、4及12周疼痛视觉模拟量表（VAS）、28关节疾病活动度（DAS28）、灰阶超声（GSUS）、能量多普勒超声（PDUS）评分及治疗有效率。结果 超声引导组治疗过程中不良反应发生率为2.70%（1/37），触诊引导组为20.00%（5/25），差异有统计学意义（P=0.03）。超声引导组治疗后4、12周VAS评分及DAS28评分均低于触诊引导组（P均<0.01）；治疗后2、4及12周PDUS评分均低于触诊引导组，治疗后12周GSUS评分低于触诊引导组（P均<0.01）；治疗后4、12周治疗有效率均高于触诊引导组（P均<0.05）。结论 超声引导下局部注射治疗RA手腕部腱鞘炎的疗效及安全性均较好。 |
| 英文摘要: |
| Objective To explore the clinical efficacy of ultrasound-guided local injection in treatment of rheumatoid arthritis (RA) patients with hand and wrist tenosynovitis. Methods Totally 62 RA patients with hand and wrist tenosynovitis were randomly divided into ultrasound-guided injection (USGI) group (n=37) and conventional blind injection (CBI) group (n=25) and underwent USGI or CBI of betamethasone and lidocaine mixture, respectively. The ratio of adverse effect during the therapeutic process was compared between the two groups. Before treatment and 2, 4 and 12 weeks after treatment, the pain visual analogue scale (VAS), disease activity score in 28 joints (DAS28), gray scale ultrasound (GSUS) and power Doppler ultrasound (PDUS) scores, as well as therapeutic efficiency were compared between the two groups. Results The ratio of adverse effect of USGI group was 2.70% (1/37), lower than that of CBI group (5/20, 20.00%; P=0.03). VAS and DAS28 scores of USGI group 4 and 12 weeks after treatment were lower than those in CBI group (all P<0.01). PDUS scores of USGI group 2, 4 and 12 weeks after treatment were lower than those in CBI group (all P<0.01), respectively, while GSUS score of USGI group was lower than that of CBI group 12 weeks after treatment (P<0.01). The efficiency of USGI group 4 and 12 weeks after treatment was higher than that in CBI group (both P<0.05). Conclusion Ultrasound-guided local injection is safe and efficient in treatment of RA patients with hand and wrist tenosynovitis. |
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