通过皮肤释放与类固醇注射在有触发指的成年人中的效果:一项随机临床试验
Mandeep Karki1, Rachit Sharma1, Dev Ram Sunuwar2
1Department of Orthopaedics, Nepal Orthopaedic Hospital, Kathmandu, Nepal.
BMC musculoskeletal disorders
|October 1, 2025
概括
与类固醇注射相比,A1轮的穿皮释放为触发指提供了卓越的功能改善和疼痛减轻. 这种微创手术为那些对保守护理不反应的患者提供了更有效的治疗选择.
科学领域:
- 整形外科手术 整形外科手术
- 手术手术手术手术手术
- 肌肉骨系统疾病 肌肉骨系统疾病
背景情况:
- 触发指 (TF) 引起显著的疼痛,并限制了手的功能.
- 虽然穿皮A1滑轮释放对TF治疗有希望,但与类固醇注射进行比较的有力证据有限.
- 这项研究解决了对尼泊尔人口的比较证据的需求.
研究的目的:
- 为了比较穿皮A1滑轮释放与局部类固醇注射治疗触发指的疗效.
- 为了评估功能结果,减轻疼痛,以及A1轮和肌厚度的变化.
主要方法:
- 一项随机临床试验,涉及92名耐火触发指的成年患者.
- 干预包括穿皮A1滑轮释放和局部类固醇注射.
- 评估的结果包括Quinnell的分类,VAS疼痛得分,以及干预后六个月A1轮/肌厚度.
主要成果:
- 与类固醇注射相比,穿皮A1轮释放显示出明显更好的功能改善 (p < 0.001,中等效果大小) 和更大的疼痛减轻 (p < 0.001,大效果大小).
- 类固醇注射在减少A1轮厚度方面更有效 (p=0.011,大效果尺寸).
- 这两种干预都减少了肌厚度,在注射类固醇后观察到更大的减少 (p < 0.001,巨大的效果大小).
结论:
- 穿皮A1滑轮释放优于类固醇注射,可以改善功能移动性和缓解触发指患者的疼痛.
- 类固醇注射可以更大程度地减少A1轮厚度.
- 建议进行更多的多中心试验,使用更大,更多样化的队列来加强证据基础.
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