实时b超引导下经皮跖腱膜切断术治疗顽固性跖腱膜炎

《实时b超引导下经皮跖腱膜切断术治疗顽固性跖腱膜炎》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

1、实时B超引导下经皮跖腱膜切断术治疗顽固性跖腱膜炎作者：程迅生，章仁品，罗福成，吴端，赵克义【摘要】[目的]探讨实时B超引导下经皮跖腱膜切断术治疗顽固性跖腱膜炎的临床疗效。[方法]从1997年6月～2007年5月共对472例顽固性跖腱膜炎患者共611足行实时B超引导下经皮跖腱膜切断术。472例患者中男177例，女295例;年龄20～71岁(平均53.4岁);体态肥胖者176例、正常者279例、瘦弱者17例。单足发病者285例、双足发病者187例，病程6个月～20年(中位数12个月)。对病程大于6个月、VA

2、S(VisualAnalogScale)值≥6、B超检查提示有跖腱膜跟骨附着部明显增厚等跖腱膜炎表现的611足行手术治疗。术前VAS值为6～10分(平均8.4分)。术后有376例患者获得长期随防，随防时间为6～36个月(平均18.4个月)。[结果]术后VAS值为0者有349例(占92.8%);VAS值为1～2者有27例(7.2%)。术后达最佳疗效所需要的时间为7d～6个月，其中术后达最佳疗效所需要的时间为7～14d者有302例(80.3%)，为2～3个月者有56例(14.9%)，为4～6个月者有18例(

3、4.8%)。所有病人均无足底内、外侧血管、神经损伤;均无切口感染;无明显切口瘢痕形成。[结论]实时B超引导下经皮跖腱膜切断术是治疗顽固性跖腱膜炎较为简便、安全有效的手术方法。【关键词】跖腱膜炎;经皮跖腱膜切断术;实时B超引导15　　Abstract:[Objective]Toevaluatetheeffectsofpercutaneousplantarfasciotomyguidedbyreal-timeB-ultrasoundinthetreatmentofrecurrentplantarfascii

4、tis.[Method]FromJune1997toMay2007,611feetof472patientssufferingfromrecurrentplantarfasciitisweretreatedwithpercutaneousplantarfasciotomyguidedbyreal-timeB-ultrasound.Allthepatientswereagedfrom20～71years(mean53.4years)withthedurationofdiseasefrom6monthsto

5、20years(median12months).Therewere177malesand295females.Onefootwasinvolvedin285andtwofeetin187patients.Atotalof611feet,withtheillnessdurationmorethan6monthsandVAS(VisualAnalogScale)≥6andhavingB-ultrasoundmanisfestationssuchasthickeningofplantarfasciaoncal

6、caneum,wereunderwentpercutaneousplantarfasciotomyguidedbyreal-timeB-ultrasound.BeforeoperationVASwas6to10(mean8.4).Totally376patientswerefollowedfrom6to36months(mean18.4months).[Result]PostoperativeVASwas0in349(92.8%),1～2in27patients(7.2%).Thetimeneededt

7、oachievebestpostopetativeeffectwas7daysto6months.Ofallthepatients,302(80.3%)achievedthebesteffectwithin7to14days,56(14.9%)within2to3monthsand18(4.8%)within4～615months.Nopatientswerefoundtohavecomplicatedincisioninfectionorinjuriestomedialorlateralplantar

8、vesselsandnerves.Incisionscarwasnotobviousinallcases.[Conclusion]Itcanbeconcludedthatpercutaneousplantarfasciotomyguidedbyreal-timeB-ultrasoundisasimple,safeandeffectiveoperativeprocedureinthetreatmentofrecurrentplantarfas