冲击波疼痛治疗课件.ppt

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1、体外冲击波疗法有效治疗范围RadialExtensionHandpiece手柄表面，高能流密度surface,highED0,35mJ/mm2深度，低能流密度depth,lowED探头Transmitter在组织中传播spreadsinthetissueED:能流密度ED:energyfluxdensity生物效应Biologicaleffects声学边界的能量释放Energyreleaseatacousticboundaries空化作用Cavitation增加细胞壁的通透性Increaseofcellwallpermeability刺激微循环（血液、淋巴）S

2、timulationofMicrocirculation(Blood,Lymph)释放P物质ReleaseofSubstanceP减少非髓鞘神经Reductionofunmyelinatednerves释放一氧化氮（血管舒张，细胞新陈代谢增加，血管新生，抗炎作用）ReleaseofNitricoxide(vasodilation,increasedcellmetabolism,neoangogenesis,anti-inflammatoryeffect)抗菌作用Antibacterialeffect刺激生长因子（血管、骨骼、胶原蛋白新生）Stimulation

3、ofGrowthfactors(neogenesisofvessels,bone,collagen)刺激干细胞StimulationofStemcells绝对禁忌症ABSOLUTECONTRAINDICATIONS妊娠Pregnancy血栓症thrombosis血凝固紊乱（血友病）coagulationdisorders(haemophilia)肿瘤疾病tumourdiseases急性炎症acuteinflammation目标治疗区脓肿pusfocusinthetargetarea相对禁忌症RELATIVECONTRAINDICATIONS抗凝血剂使用者，特别

4、是苯丙香豆素（维生素K拮抗剂）useofanticoagulants,especiallymarcumar(vitaminkantagonist)有多发性神经病的糖尿病polyneuropathyincaseofdiabetesmellitus可的松治疗结束六周后才能使用体外冲击波治疗cortisonetherapyupto6weeksbeforefirstESWTtreatment风湿性疾病rheumaticdisease肿胀swelling变红reddening血肿haematomas瘀点petechiae灼伤般疼痛感painlikesunburn治疗初期

5、病情恶化firstworsening副作用SIDEEFFECTS冲击波治疗的益处BenefitsofShockWaveTreatment几次治疗后，疼痛即得到缓解/减轻painrelief/reductionafterafewtreatingsessions治疗依从性好thecomplianceisverygood治疗后病人能直接感受到第一疗效thepatientscanfeelfirsteffectsdirectlyafterthetreatment能治疗复杂症状及相关适应症treatmentofcomplexsymptoms/indicationsposs

6、ible冲击波治疗的益处BenefitsofShockWaveTreatment治疗结缔组织treatmentofconnectivetissue活化淋巴系统activationoflymphaticsystem大面积治疗treatmentoflargeareaspossible作用于神经系统（门控制、疼痛记忆）effectsonthenervoussystem(gatecontrol,painmemory?)经典适应症CLASSICINDICATIONS经典适应症ClassicIndicationsCalcifictendonitis/shoulderpai

7、n钙化性肌腱炎/肩痛Achillodynia跟腱痛Plantarfasciitis足底筋膜炎Ulnarhumeralepicondylitis肱骨内上踝炎Tibialstresssyndrome胫骨压力症候群Radialhumeralepicondylitis肱骨外上髁炎Trochanterictendonitis转子肌腱炎Patellartendonitis髌腱炎治疗方法PROTOCOL查找主要痛点和其他痛点lookforthemainandotherpainpoints与病人密切交谈closedialoguewiththepatient生物反馈biofee

8、dback2000次发散式冲击波rad