北京大学学报(医学版) ›› 2019, Vol. 51 ›› Issue (2): 265-267. doi: 10.19723/j.issn.1671-167X.2019.02.012

• 论著 • 上一篇    下一篇

超声引导下髋关节药物注射在关节镜盂唇修复术后康复中的应用

张翠平1,刘佩佩1,傅强1,高冠英2,崔立刚1,(),徐雁2,(),王健全2   

  1. 1. 北京大学第三医院 超声科, 北京 100191
    2. 北京大学第三医院 运动医学研究所, 北京 100191
  • 收稿日期:2018-08-20 出版日期:2019-04-18 发布日期:2019-04-26
  • 通讯作者: 崔立刚,徐雁 E-mail:cuijuegang@126.com;yanxu@139.com
  • 基金资助:
    北京大学第三医院临床重点项目及(Y75478-03);首都临床特色应用研究与成果推广项目(Z151100004015092)

Application of ultrasound-guided hip joint drug injection in the postoperative rehabilitation of arthroscopie repair of acetabular labral tears

Cui-ping ZHANG1,Pei-pei LIU1,Qiang FU1,Guan-ying GAO2,Li-gang CUI1,(),Yan XU2,(),Jian-quan WANG2   

  1. 1. Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
    2. Institute of Sports Medicine, Peking University Third Hospital, Beijing 100191, China
  • Received:2018-08-20 Online:2019-04-18 Published:2019-04-26
  • Contact: Li-gang CUI,Yan XU E-mail:cuijuegang@126.com;yanxu@139.com
  • Supported by:
    the Key Clinical Project, Youth Project of Peking University Third Hospital(Y75478-03);the Capital Foundation for Clinical Characteristics and Application Research(Z151100004015092)

RICH HTML

  

摘要:

目的: 探讨超声引导下髋关节药物注射在髋关节镜盂唇修复术后促进康复中的临床应用。方法: 纳入2015年6月至2017年5月于北京大学第三医院行髋关节镜盂唇修复术,术后1~6个月[平均(2.3±0.6)个月]仍有髋部疼痛导致康复期康复训练受限,但影像学检查显示盂唇愈合良好的36例患者,其中2例患者为双侧,共计38侧髋关节,行超声引导下髋关节疼痛阻滞治疗。对注射治疗前及治疗后满4周时患者髋部疼痛程度进行评分,应用SPSS 21.0统计学软件进行数据分析,同时随访患者髋关节功能状况,计算髋关节药物注射治疗的有效率[有效率=(“优良”+“好转”)例数/总例数×100%]。髋部疼痛程度评估采用视觉模拟评分法(visual analogue score, VAS)评估,疼痛程度分为0~10分,0分为无疼痛感,10分为难以忍受的剧烈疼痛。髋关节功能状况通过髋关节活动度进行评估。疗效“优良”指髋部无疼痛或偶有轻微疼痛,Patrick试验转阴性,运动功能不受限;“好转”指疼痛明显减轻,运动功能稍受限;“无效”指治疗前后疼痛和运动功能无明显改善,Patrick试验阳性。结果: 在接受髋关节药物注射治疗前,患者髋部疼痛程度VAS评分为(5.46±1.46)分,注射治疗后满4周时VAS评分为(2.01±0.53)分,VAS值明显减低,差异有统计学意义(P<0.05);药物注射治疗后,髋关节活动度有明显提高,治疗有效率为84.2%。结论: 对髋关节镜盂唇修复术后仍存在疼痛、功能受限的患者,行超声引导下髋关节药物注射可有效减轻髋部疼痛,改善髋关节活动度,促进髋关节功能重建。

关键词: 髋关节, 盂唇撕裂, 药物注射, 关节镜检查, 超声

Abstract:

Objective: To explore the clinical application of ultrasound-guided hip joint drug injection in the postoperative rehabilitation of arthroscopie repair of acetabular labral tears.Methods: This research retrospectively analyzed a total of 38 hips from 36 patients (2 of them were bilateral) whose imaging examination showed acetabular labral well healed but the rehabilitating training was limited due to hip pain after arthroscopie repair of acetabular labral tears in our hospital between June 2015 and May 2017. All the patients underwent ultrasound-guided hip joint drug injection treatment. Through comparing the pain and the function of hip before and after drug injection, the clinical application values of ultrasound-guided hip joint drug injection in the postoperative rehabilitation of arthroscopie repair of acetabular labral tears were explored. The degree of hip pain was assessed by visual analogue score (VAS), which were scored before and after the injection. The hip function was assessed by the hip range of activity. The SPSS 21.0 statistical software was used for the data analysis. The effective rate of hip injection was calculated, which was defined as: (“excellent” + “good”)/total number of cases×100%. The degree of hip pain was assessed by VAS, which was divided into 0 to 10 points with 0 for no pain and 10 for unbearable severe pain. The function of hip was assessed by the hip range of activity. The therapeutic effect of “excellent” meant no pain or occasional slight pain in the hip, along with Patrick test was negative and hip joint was not limited; the therapeutic effect of “good” meant that the pain was significantly reduced, and the hip’s activity was slightly restricted. “No effect” meant that the pain of hip was not relieved, and the Patrick test was positive.Results: The VAS score of the patient before drug injection was 5.46±1.46, and the VAS score was 2.01±0.53 after drug injection 4 weeks later. The score of the latter was significantly lower than that of the former, and the difference was statistically significant (P<0.05). The hip joint activity after ultrasound-guided hip joint drug injection was significantly improved. The therapeutic effective rate was 84.2%.Conclusion: For patients with hip pain and limitations after arthroscopie repair of acetabular labral tears, ultrasound-guided drug injection can effectively reduce hip pain, improve hip activity, and promote hip functional reconstruction.

Key words: Hip joint, Labrum tear, Drug injection, Arthroscopy, Ultrasound

中图分类号: 

  • R684

图1

箭头示髋关节前隐窝、股骨头颈交界处磨骨后凹陷处"

图2

穿刺针刺入髋关节腔前隐窝磨骨凹陷处(箭头示穿刺针)"

图3

箭头示注药后髋关节腔内填充无回声"

[1] 郑博文, 任杰, 曹君 , 等. 超声引导下髋关节穿刺注药的临床应用研究[J]. 中国超声医学杂志, 2013,29(1):65-68.
[2] 陈孝平 . 8年制外科学 [M]. 2版. 北京: 人民卫生出版社, 2010: 886-887.
[3] Ha YC, Kim KC, Shin YE . Patient satisfaction after arthroscopie repair of acetabular labral tears[J]. Clin Orthop Surg, 2014,6(2):159-164.
doi: 10.4055/cios.2014.6.2.159
[4] 左辉, 赵树恩, 姚军 , 等. 得宝松的药理作用、临床应用及不良反应的评价[J]. 实用疼痛学杂志, 2004,12(2):40-42.
[5] Shankar H . Ultrasound guided hip joint injections: a new scanning routine for easy methodical training[J]. Pain Practice, 2012,12(1):80-81.
doi: 10.1111/ppr.2011.12.issue-1
[6] Smith J, Handle MF, Weingarten TN . Accuracy of sonographicauy guided intra-article injections in the native adult hip[J]. Ultrasound Med, 2009,28(3):329-335.
doi: 10.7863/jum.2009.28.3.329
[7] Sotka CM, Saboeim G, Adler RS . Ultrasound-guilded adult hip injections[J]. Vasc Interv Radiol, 2005,16(8):1121-1123.
doi: 10.1097/01.RVI.0000167855.43900.74
[1] 原晋芳, 王新利, 崔蕴璞, 王雪梅. 尿促黄体生成素在女童中枢性性早熟预测中的应用[J]. 北京大学学报(医学版), 2024, 56(5): 788-793.
[2] 汪琪伟, 包鹏宇, 洪士皓, 杨昕, 王宇, 曹永平. 改良股骨颈截骨术在伴严重屈曲畸形强直性脊柱炎患者手术治疗过程中的疗效[J]. 北京大学学报(医学版), 2024, 56(5): 884-889.
[3] 王明瑞,刘军,熊六林,于路平,胡浩,许克新,徐涛. 经皮微通道-微电子肾镜-微超声探针碎石术治疗1.5~2.5 cm肾结石的疗效和安全性[J]. 北京大学学报(医学版), 2024, 56(4): 605-609.
[4] 杨捷,冯杰莉,张树栋,马潞林,郑清. 经食管超声心动图在肾切除术联合Mayo Ⅲ~Ⅳ级静脉瘤栓取栓术不同手术方式中的临床作用[J]. 北京大学学报(医学版), 2024, 56(4): 631-635.
[5] 陈延,李况蒙,洪锴,张树栋,程建星,郑仲杰,唐文豪,赵连明,张海涛,姜辉,林浩成. 阴茎海绵体注射试验对阴茎血管功能影响的回顾性研究[J]. 北京大学学报(医学版), 2024, 56(4): 680-686.
[6] 魏越,姚兰,陆希,王军,蔺莉,刘鲲鹏. 胃超声检查评估剖宫产产妇术前饮用碳水化合物后胃排空的效果[J]. 北京大学学报(医学版), 2023, 55(6): 1082-1087.
[7] 魏越,陆希,张静,刘鲲鹏,王永军,姚兰. 术前2 h口服碳水化合物对妇科腹腔镜特殊体位手术患者胃容量及反流误吸风险的影响[J]. 北京大学学报(医学版), 2023, 55(5): 893-898.
[8] 傅强,高冠英,徐雁,林卓华,孙由静,崔立刚. 无症状髋关节前上盂唇撕裂超声与磁共振检查的对比研究[J]. 北京大学学报(医学版), 2023, 55(4): 665-669.
[9] 刘杨,程昉,王艳玲,艾香艳,朱振航,赵福涛. 唾液腺超声对干燥综合征的诊断价值[J]. 北京大学学报(医学版), 2022, 54(6): 1123-1127.
[10] 王昱,张慧敏,邓雪蓉,刘伟伟,陈璐,赵宁,张晓慧,宋志博,耿研,季兰岚,王玉,张卓莉. 尿枸橼酸定量检测在原发性痛风患者肾结石诊断中的应用价值[J]. 北京大学学报(医学版), 2022, 54(6): 1134-1140.
[11] 翟书珩,胡攀攀,刘晓光. 术中超声辅助下环形减压术治疗多节段胸椎后纵韧带骨化症[J]. 北京大学学报(医学版), 2022, 54(5): 1021-1027.
[12] 邢海英,陈玉辉,许珂,黄点点,彭清,刘冉,孙葳,黄一宁. 三维超声血管斑块定量分析技术评估颈动脉粥样硬化斑块[J]. 北京大学学报(医学版), 2022, 54(5): 991-999.
[13] 邓雪蓉,孙晓莹,张卓莉. 类风湿关节炎患者足踝部体征和超声下病变的一致性[J]. 北京大学学报(医学版), 2021, 53(6): 1037-1042.
[14] 宋志博,耿研,邓雪蓉,张晓慧,张卓莉. 肌肉骨骼超声在指导银屑病关节炎临床分型中的价值[J]. 北京大学学报(医学版), 2021, 53(6): 1061-1066.
[15] 彭喆,丁亚敏,裴林,姚海红,张学武,唐素玫. 痛风患者发生关节及肌腱内晶体沉积的临床特点[J]. 北京大学学报(医学版), 2021, 53(6): 1067-1071.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!