体外冲击波治疗慢性跟腱炎的临床疗效△

Clinical efficacy of extracorporeal shock wave therapy for chronic Achilles tendinitis

摘要:

［目的］ 探讨体外冲击波治疗 （extracorporeal shock wave therapy, ESWT） 慢性跟腱炎的疗效。［方法］ 回顾性分析 2017 年 6 月—2021 年 10 月于骨科门诊行 ESWT 治疗慢性跟腱炎患者 187 例。所有患者均接受 5 次 ESWT，间隔 1 周，每次 2 000 个脉冲 （0.45 mJ/mm² ，10Hz）。采用疼痛 VAS 和 AOFAS 踝与后足评分评价临床效果。［结果］所有患者治疗期间无严重不良反应，随访 12 个月以上。患者能够恢复运动情况，治疗后 3 个月为 20.9%，6 个月为 69.0%，12 个月时为 86.1%。末次随访时，135 例疼痛完全缓解，占 72.2%；26 例低强度运动时不引起疼痛，只在高强度运动时疼痛，占 13.9%；10 例日常生活不引起疼痛，只在体育运动时疼痛，占 5.3%；16 例仍然主诉疼痛，占 8.6%。随时间推移 （治疗前，治疗后 3 个月，治疗后 6 个月， 治疗后 12 个月） 患者 VAS 评分显著减小[(7.3±0.9) 分, (2.8±0.7) 分, (2.4±0.5) 分, (2.0±0.7) 分, P<0.05]，而 AOFAS 评分显著增加 [(72.1±4.7) 分, (83.2±4.7) 分, (87.2±3.7) 分, (90.0±5.0)分, P<0.05]。［结论］冲击波治疗慢性跟腱炎操作简单，患者依从性好，安全有效。

Abstract:

[Objective] To explore the clinical efficacy of extracorporeal shock wave therapy (ESWT) for chronic Achilles tendinitis. [Methods] A retrospective study was conducted on 187 patients who received ESWT for chronic Achilles tendinitis in the outpatient depart- ment from June 2017 to October 2021. All patients received five ESWTs 1 week apart, each with 2 000 pulses (0.45 mJ/mm2 , 10Hz) . The clini- cal results were evaluated by pain VAS and AOFAS ankle and hindfoot scores. [Results] All patients had no serious adverse reactions during treatment, and were followed up for more than 12 months. The patients who were able to resume physical activity proved of 20.9% at 3 months, 69.0% at 6 months, and 86.1% at 12 months after treatment. Of them, 135 patients had pain completely relieved, accounting for 72.2%; 26 pa- tients had no pain in low intensity exercise, while pain in high-intensity exercise, accounting for 5.3%; 10 patients had no pain in daily life, while pain only in exercise, accounting for 5.3%; 16 patients continued to complain of pain, accounting for 8.6% at the latest follow-up. The VAS score for pain decreased significantly [(7.3±0.9) , (2.8±0.7) , (2.4±0.5) , (2.0±0.7) , P＜0.05] , while AOFAS score significantly increased [(72.1±4.7) , (83.2±4.7) , (87.4±3.7) , (90.0±5.0) , P＜0.05] over time (befor treatment, 3, 6 and 12 months after treatment) . [Conclusion] The extracorporeal shockwave therapy for chronic Achilles tendinitis is simple, safe and effective, with good patient’s compliance.