【作者】 冼超平；

【导师】 黄枫；

【作者基本信息】 广州中医药大学 ， 中医骨伤科学， 2008， 硕士

【摘要】 目的:观察微型骨锚治疗对指伸肌腱止点断裂患者术后肌腱止点稳定性及功能活动的影响,进一步以活动范围评定结合影像学检查及术后康复时间长短等作为指标评价中医药对微型骨锚重建指伸肌腱止点术后康复以及功能锻炼的临床疗效。方法:采取前瞻性随机对照试验的研究方法,通过对2006年7月到2008年3月之间41例应用微型骨锚重建指伸肌腱止点的病例,按简单随机化法分为治疗组和对照组。治疗组每次肌腱止点重建术后基础治疗,4周拔除克氏针后用祛风通络散熏洗患指,并指导患指的功能锻炼;对照组每次肌腱止点重建术后基础治疗,4周后拔除克氏针不应用中药熏洗,仅指导患指的功能锻炼。临床观察患者3个月至半年。观察两组病例拔除克氏针后患指的活动范围,患指的影像学表现,以及患指的康复时间等。结果:1.治疗组与对照组的患者在拔除克氏针后同等时间内患指的活动范围,患指的影像学表现,以及患指的康复时间相比较,有显著性差异(P＜0.05),提示治疗组可加快患指的肌腱愈合,促进患指的功能锻炼。但在患指影响学表现上,无显著性差异(P＞0.05),提示微型骨锚治疗对术后肌腱止点提供可靠的稳定性,恢复较好的形态。2.治疗组与对照组的病例治愈率相比较,无显著性差异(P＞0.05),提示微型骨锚重建指伸肌腱止点是行之有效的手指伸肌腱Ⅰ区损伤的治疗方法。3.治疗过程中进行血、尿、大便常规及心、肝、肾功能检查,两组均无异常变化,治疗过程中未见局部过敏反应或其他不良反应。结论:1.微型骨锚重建指伸肌腱止点术后应用祛风通络散熏洗,可加快患指的肌腱愈合,促进患指的功能锻炼。2.微型骨锚重建指伸肌腱止点,操作安全、简便,固定牢固可靠,是行之有效的手指伸肌腱Ⅰ区损伤的治疗方法。3.治疗组及对照组病例在安全性指标上均无异常,说明应用祛风通络散熏洗配合微型骨锚重建指伸肌腱止点在安全性上可行的。更多还原

【Abstract】 Objective: The aim of the study was to assess the influence of stability and activities after the operation of micro-anchor in reestablishment of the adhesion of tendon of extensor digitorum, further to confer the clinical effect of Chinese medicine for them through observing the scale of activities, the time of recovery and the behavior of radiology of the wounded fingers.Methods:41 patients from July ,2006 to March ,2008 treating by Micro Arc bone Anchor were randomly assigned to the treating group or to the control group. The treating group was treated by Micro Arc bone Anchor combined with herbal fume bathing, and the control group was treated only by Micro Arc bone Anchor. The course last 3 months to 6 months. After removing spiculate fixing object, the scale of activities, the time of recovery and the behavior of radiology of two groups were observed and compared.Results:1. The index of the scale of activities and the time of recovery of treating group and control group ,within the same interval after removing spiculate fixing object, has significant difference (P<0.05) .It shows that management of treating group could quicken the the healing of tendons and faciliate the function exercise of wounded fingers,while the behavior of radiology of two groups have no significant difference (P>0. 05) which showed that the micro-anchor in reestablishment of adhesion of tendon of extensor digitorum is reliable and effective.2. The cure rate of treating group and control group have no significant difference (P>0. 05) that showed the micro-anchor in reestablishment of the adhesion of tendon of extensor digitorum is a reliable means for the damnification of Region I of tendon of extensor digitorum.3. Both of the two groups have no significant difference in routine blood test, routine urine test, routine stool test, heart function, liver function, kidney function during the study comparing with the pre-treatment .There is no allergic reaction and adverse drug reactions during the treating.Conclusion:1. Qufengtongluo powder combined with micro Arc bone Anchor in reestablishment of the adhesion of tendon of extensor digitorum, could quicken the healing of tendons and faciliate the function exercise of wounded fingers.2. the micro-anchor in reestablishment of the adhesion of tendon of extensor digitorum is a reliable means for the damnification of Region I of tendon of extensor digitorum due to safe , convenient manipulation and reliable , stable effect.3. Both of the two groups have no difference on safty index, so qufengtongluo powder combined with micro-anchor in reestablishment of the adhesion of tendon of extensor digitorum is safe and feasible.更多还原