体外聚焦状冲击波治疗下肢不同部位骨髓水肿综合征患者的疗效

doi:10.13481/j.1671-587x.20160633

吉林大学学报(医学版) ›› 2016, Vol. 42 ›› Issue (06): 1215-1219.doi: 10.13481/j.1671-587x.20160633

体外聚焦状冲击波治疗下肢不同部位骨髓水肿综合征患者的疗效

马丽波, 李剑锋, 闫金玉, 张淑莲, 赵君, 夏润福, 张旭, 李冬生

内蒙古医科大学第二附属医院骨科, 内蒙古呼和浩特 010030

收稿日期:2016-07-04 出版日期:2016-11-28 发布日期:2016-12-02
通讯作者: 李剑锋,副主任医师(Tel:0471-6351194,E-mail:jianfeng0471@163.com) E-mail:jianfeng0471@163.com
作者简介:马丽波(1966-),女,内蒙古自治区呼和特市人,副主任护师,主要从事骨科疾病临床康复护理方面的研究。
基金资助:
内蒙古自治区科技厅自然科学基金资助课题（2015MS0898）

Curative effect of extracorporeal focused shock wave therapy in treatment of patients with bone marrow edema syndrome of lower limbs

MA Libo, LI Jianfeng, YAN Jinyu, ZHANG Shulian, ZHAO Jun, XIA Runfu, ZHANG Xu, LI Dongsheng

Department of Orthopedics, Second Affiliated Hospital, Inner Mongolia Medical University, Hohhot 010030, China

Received:2016-07-04 Online:2016-11-28 Published:2016-12-02

摘要/Abstract

摘要：

目的：观察体外聚焦状冲击波治疗下肢不同部位骨髓水肿综合征（BMES）患者的临床疗效，为临床治疗BMES提供一种新的有效方法。方法：选择确诊为下肢不同部位BMES患者39例，采用HK-ESWO-AJⅡ型冲击波治疗仪进行治疗。以骨髓水肿体表投影区及其相邻骨质为冲击点，工作电压为7~10 kV，频率为60 min^-1，冲击强度为0.18~0.25 mJ·mm^-2，每个治疗点共冲击1 000次，每5 d治疗1次，共治疗4次。治疗期间患者以卧床休息为主，尽量减少负重活动时间。治疗前后分别采用视觉模拟评分法（VAS）评定患者的疼痛情况，关节功能评分评定患者下肢关节功能，采用功能独立性评定（FIM）指数评定患者的独立生活能力，并进行出院后12~24个月的随访。结果：与治疗前比较，治疗后患者VAS评分降低（P<0.05）、关节功能评分及FIM指数明显升高（P<0.05）。经过12~24个月的随访，2例患者有复发现象，其中1例发生在股骨头颈部位，另1例发生在股骨远端，经再次冲击波治疗4次后患者BMES症状恢复良好，无患者出现股骨头及其他部位骨坏死现象。结论：体外聚焦状冲击波治疗可以明显改善患者疼痛症状及骨髓水肿征象；下肢BMES有复发倾向，但是无明显骨坏死或其他疾病转归趋势。

关键词: 聚焦状冲击波, 下肢骨髓水肿综合征, 视觉模拟评分, 骨坏死, 关节功能, 独立功能

Abstract:

Objective: To observe the curative effect of extracorporeal shock wave therapy in the treatment of the patients with bone marrow edema syndrome(BMES) at different positions of lower limbs,and to provide a new and effective method for treatment of BMES.Methods: A total of 39 patients with BMES at different positions of lower limbs were selected. All the patients were treated with extracorporeal focused shock wave by HK-ESWO-AJⅡ apparatus at surface projection of BMES. The voltage was 7-10 kV. The frequency was 60 min^-1. The intensity was 0.18-0.25 mJ·mm^-2. Every treatment point was treated with 1 000 times, once per 5 d for 4 courses. All the patients were told to reduce weight-bearing during the therapy. The visual analogue score(VAS) was used to detect the pain status of the patients;the joint function score was used to detect the joint funtion of lower limbs of the patients;the function independent measure(FIM) index was used to evaluate the ability to live independently of the patients.Results: Compared with before treatment, the VAS score of patients was decreased(P<0.05) and the joint function score and FIM index were increased after treatment(P<0.05). A total of 2 patients were found BMES recurrence during 12-24 months follow-up; one patients occurred at femur head and neck and another patient occurred at distal femur. Both of them were recovery after 4 times of shock wave therapy.There was no patient suffered from osteonecrosis. Conclusion: Extracorporeal focused shock wave therapy could improve the pain symptom and bone marrow edema signs of the BMES patients. Although BMES of lower limbs has recurrence tendency, there is no obvious trend of osteonecrosis and other diseases.

Key words: extracorporeal focused shock wave, bone marrow edema syndrome, function independent measure, osteonecrosis, visual analogue score, joint function

中图分类号:

R747.5

马丽波, 李剑锋, 闫金玉, 张淑莲, 赵君, 夏润福, 张旭, 李冬生. 体外聚焦状冲击波治疗下肢不同部位骨髓水肿综合征患者的疗效[J]. 吉林大学学报(医学版), 2016, 42(06): 1215-1219.

MA Libo, LI Jianfeng, YAN Jinyu, ZHANG Shulian, ZHAO Jun, XIA Runfu, ZHANG Xu, LI Dongsheng. Curative effect of extracorporeal focused shock wave therapy in treatment of patients with bone marrow edema syndrome of lower limbs[J]. Journal of Jilin University Medicine Edition, 2016, 42(06): 1215-1219.

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体外聚焦状冲击波治疗下肢不同部位骨髓水肿综合征患者的疗效

Curative effect of extracorporeal focused shock wave therapy in treatment of patients with bone marrow edema syndrome of lower limbs

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