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德奎尔维恩肌炎管理的进展:一个全面的网络元分析
Han Hong Chong1, Akhilesh Pradhan1, Mohit Dhingra1
1Department of Trauma & Orthopaedic, University Hospitals of Leicester National Health Service (NHS) Trust, Leicester, United Kingdom.
The Journal of hand surgery
|April 13, 2024
概括
皮质类固醇注射仍然是对德奎尔温紧肌炎的首要治疗方法,提供有效的止痛. 身体外冲击波疗法是治疗这种疾病的可行的二次选择.
科学领域:
- 整形外科和运动医学
- 类风湿病学 类风湿病学
- 物理疗法物理治疗
背景情况:
- 德·奎尔维恩肌炎是一种常见的疾病,导致手腕疼痛和功能限制.
- 非手术治疗广泛使用,但对比疗效的数据有限.
研究的目的:
- 进行一个网络元分析,评估德奎尔温紧突炎非手术治疗方式的比较有效性.
- 根据短期,中期和长期结果确定最佳的非手术干预措施.
主要方法:
- 按照PRISMA指南进行系统审查和网络元分析.
- 包括14个随机对照试验 (RCT).
- 根据随访持续时间对结果进行分类:短期 (≤6周),中期 (6周6个月) 和长期 (1年).
主要成果:
- 与安慰剂相比,体外冲击波疗法 (ESWT) 显示出显著的短期疼痛减轻.
- 在短期内,ESWT排名最高,其次是用造和激光疗法进行的皮质类固醇注射 (CSI).
- 长期发现表明,单独使用CSI和富血小板血 (PRP) 注射可持续缓解疼痛;与正结合的CSI也显示出有前途.
结论:
- 带有短期不动化的皮质类固醇注射是对德·奎尔温紧肌炎的主要有效治疗方法.
- 身体外冲击波疗法是推的二次治疗选择.
- 隔离治疗注射应谨慎使用,因为与安慰剂相比,实质性益处的证据有限.
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