【摘要】 目的探讨体外冲击波对距骨骨软骨损伤的临床疗效。方法收集河北医科大学第三医院2019年3月—2019年7月收治的距骨骨软骨损伤患者40例,随机分为两组,每组20例。实验组采用体外冲击波治疗,能量1.8～2.5 bar,频率5 Hz,选取2～3个治疗点,每个点冲击1000次,1次/2 d,6次一个疗程。对照组采用非甾体抗炎药治疗。两组患者治疗前及治疗结束后3个月,通过视觉模拟评分法(visual analogue scale,VAS)评估踝关节疼痛,美国足踝外科协会(American orthopaedic of foot and ankle society,AOFAS)踝与后足评分评估踝关节功能,MRI评价损伤面积,应用Footscan足底压力系统比较治疗前后患者足底压力分布特征变化。结果与治疗前比较,两组治疗后患者VAS评分、AOFAS评分均有所改善,且实验组患者评分改善均优于对照组(P<0.05);实验组MRI显示损伤面积缩小明显(P<0.05),距下关节活动范围改善(P<0.05);实验组患侧足在行走中的最大压力及平均压力均增加(P<0.05),患者足跟着地期缩短,全足支撑期延长(P<0.05)。结论体外冲击波对距骨骨软骨损伤的治疗效果满意,步态分析可对临床治疗效果进行定量评价,有助于治疗方案的制定。更多还原

【Abstract】 Objective To investigate the clinical effect of extracorporeal shock wave on osteochondral lesions of the talus(OLT).Methods 40 patients with talus cartilage injury admitted to the Third Hospital of Hebei Medical University from March 2019 to July 2019 were randomly divided into two groups,20 in each group.The experimental group was treated with extracorporeal shock wave,with energy of 1.8～2.5 bar and frequency of 5 Hz.2～3 treatment points were selected,each point was impacted 1000 times,once every two days,six times a course of treatment.Before and 3 months after treatment,ankle pain was assessed by visual analogue scale (VAS),ankle function was assessed by AOFAS and ankle function,injury area was assessed by MRI,and foot pressure distribution of patients before and after treatment was compared by Footscan plantar pressure system.Results Compared with before treatment,after treatment,VAS score and AOFAS score of patients in the two groups were improved,and the improvement of scores in the experimental group was better than that in the control group (P < 0.05).In the experimental group,MRI showed that the area of injury decreased significantly (P < 0.05),and the range of motion of subtalar joint improved (P < 0.05).In the experimental group,the maximum pressure and the average pressure of the affected side foot increased (P<0.05),the duration of the patient’s foot following the ground shortened,and the duration of the whole foot supporting prolonged (P<0.05).Conclusion The therapeutic effect of extracorporeal shock wave on taluscartilage injury is satisfactory.Gait analysis can quantitatively evaluate the clinical therapeutic effect,which is helpful for the formulation of therapeutic plan.更多还原