摘要：
目的 验证推割刀经皮微创松解术治疗狭窄性腱鞘炎的有效性及安全性.方法 选择符合纳入标准的狭窄性腱鞘炎患者,根据随机数字表及随机隐藏将患者1:1分配到推割刀组和针刀组.推割刀组采用推割刀疗法,针刀组采用传统针刀疗法,各组治疗1次.主要结局指标为治疗后第27周的治愈率,次要结局指标包括患指关节疼痛评分、患指关节活动度及扳机指征.安全性指标包括治疗并发症及不良事件.结果 纳入120人,针刀组1例患者由于病情较重自行退出,共119例患者完成研究并纳入主要结局指标的统计分析.治疗后第27周推割刀组治愈55例(91.67%),针刀组治愈39例(66.10%),差异有统计学意义(P<0.001).治疗后,2组扳机指征、疼痛、关节活动度均明显改善,而且随着时间进展,改善程度越大,差异有统计学意义(P<0.05).在第1、3、6、12、27周时间点的组间比较显示,推割刀组改善扳机指征、疼痛、关节活动度等方面均优于针刀组,差异有统计学意义(P<0.05).2组均无不良事件或并发症发生.结论 推割刀治疗狭窄性腱鞘炎的一次性治愈率较高,且疼痛、关节活动度、扳机指征等体征治疗后即刻缓解,治疗后半年内持续改善,无不良事件发生.%Objective To evaluate the effectiveness and safety of percutaneous micro-invasive release therapy by using push-cut knife on stenosal tendosynovitis. Methods The patients with stenosal tendosy-novitis were chosen according to inclusion criteria,and then divided,based on random digital table and 1:1 of random concealmert,into push-cut knife group and needle-knife group. The push-cut knife group was given push-cut knife therapy one time, and was given traditional needle-knife one time. The main outcome index was cure rate on the 27thweek after treatment, and secondary indexes included pain scores,joint range of motion (ROM) and trigger indications. The safety indexes included complications and adverse events. Results There were totally 120 patients were chosen,but one quitted due to serious disease in needle-knife group,and 119 patients completed the study and were brought into the statistical analysis of outcome indexes. On the 27thweek after treatment,there were 55 cases(91.67%) cured in push-cut knife group and 39 (66.10%) cured in needle-knife group (P<0.001). The indexes of trig-ger indications,pain and ROM were significantly relieved in 2 groups,and improved more significantly o-ver time. The comparisons at the time points of the 1st,3rd,6th,12thand 27thweeks showed that,the re-liefs of trigger indications, pain and ROM were superior in push-cut knife group than those in needle-knife group (P<0.05). There were no adverse events or complications occurred in 2 groups. Conclu-sion The push-cut knife has higher one-off cure rate in treatment of stenosal tendosynovitis. The signs of pain,ROM and trigger indications are relieved immediately after treatment,and continuously relieved af-ter half year. There are no adverse events occurred.
