自制钩刀微创治疗手指屈肌腱狭窄性腱鞘炎的疗效观察

摘要

目的 探讨自制钩刀微创治疗手指屈肌腱狭窄性腱鞘炎的临床疗效.方法 2012年7月-2015年1月门诊诊治的178例(205指)手指屈肌腱狭窄性腱鞘炎患者,依据Quinnell分级为3,4级,应用自制钩刀对患者的A1滑车进行微创切割松解,并对术后疗效进行随访.结果 本组术后均获得随访,随访时间6~18个月,平均12.7个月.术后3 h患指毛细血管充盈试验及感觉功能恢复情况均正常,切口均于1周内愈合,愈合类型Ⅰ/甲,无一例出现切口红肿、渗出等并发症.术后6个月依照Quinnell分级对患指进行疗效评定,以Quinnell分级0级为优,1级为良,2级为中,3~4级为差,其中优181指,良19指,中5指,优良率达97.6%.结论 应用自制钩刀微创治疗手指屈肌腱狭窄性腱鞘炎,可获得满意的治疗效果,值得临床推广应用.%Objective To research the the clinical effect of minimally invasive surgery by self-made hook knife in the treatment of finger flexor tendon stenosing tenosynovitis (FFTST). Methods 178 patients (205 fingers) with FFTST admitted to our hospital from July 2012 to January 2015 were involved into the study and they were all classified as 3 to 4, according to Quinnell classification standard, all patients were treated with self-made hook knife, and A1 trochlea was cut to make it loose. Results All patients were followed up from 6 to 18 months (mean 12.7 months), the capillary refill time of all patients 3 hours after surgery were normal, and they also had normal feelings in the treated fingers, all patients' incisions healed successfully (healing type I/A) in 1 week, no patient showed swollen incision or seepage, according to Quinnell classification standard 6 months after surgery:excellent(181 fingers), good(19 fingers), medium(5 fingers), the overall good-excellent rate was 97.6%. Conclusion Minimally invasive surgery by self-made hook knife is a reliable and effective treatment option for finger flexor tendon stenosing tenosynovitis.