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徐 城,刘丹彦.低强度聚焦超声治疗慢性软组织损伤性疼痛的疗效及远期评价[J].中国康复医学杂志,2015,(12):1248~1252
低强度聚焦超声治疗慢性软组织损伤性疼痛的疗效及远期评价    点此下载全文
徐 城  刘丹彦
重庆医科大学附属第一医院麻醉科,重庆,400016
基金项目:重庆市科委重点实验室专项经费;国家临床重点专科[财社(2011)170号];重庆市医学重点学科[渝卫科教(2007)2号]
DOI:
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摘要:
      摘要 目的:探讨低强度聚焦超声治疗慢性软组织损伤的安全性、有效性及远期效果。 方法:选择120例慢性软组织损伤患者,随机分为实验组(TG组:药物+理疗)和对照组(CG组:药物+假理疗),两组均在口服药物的基础上给予真假聚焦超声治疗,连续治疗5次。记录每次治疗起效时间(T),在治疗前(T1),治疗后即刻(T2)、15min(T3),30min(T4)、24h(T5)用数字评估法(NRS)评估局部疼痛,记录不良反应。1个月、3个月、6个月随访患者局部疼痛(NRS评分),功能障碍改善评分、口服止痛药的种类和数目及再次入院情况。 结果:TG组治疗后平均起效时间由(43.76±19.01)s延长至(101.50±30.35)s,差异有显著性意义(P<0.05)。TG组治疗后NRS评分由(5.28±1.02)分下降至(1.02±0.92)分,CG组由(5.49±1.02)分下降至(3.34±0.88)分,差异有显著性意义(P<0.05)。两组不同时间点NRS评分降低不同,TG组治疗总体效果优于CG组,差异有显著性意义(P<0.05)。组内比较:TG组第1—5次治疗后NRS评分与前次同一时间点比较评分有显著下降,差异有显著性意义(P<0.05)。TG组治疗结束30min后NRS评分降低最显著,差异有显著性意义(P<0.05),而治疗结束后24h NRS评分降低最不明显。两组均无不良反应发生。TG组随访1个月、3个月、6个月NRS评分逐渐增加,两两比较差异有显著性意义(P<0.05)。随着随访时间延长,功能减退、服用止痛药、再次入院的患者比例增加。 结论:低强度聚焦超声联合药物治疗慢性软组织损伤性疼痛安全、有效,总体疗效优于单独使用药物治疗;且重复多次治疗优于单次治疗效果;单次治疗30min后疼痛缓解最佳,24h后止痛效果明显衰减;其远期效果还需进一步探索更佳治疗模式和疗程。
关键词:聚焦超声  慢性软组织损伤  疗效  远期评价
The effect and long-term evaluation of low intensity focused ultrasound towards chronic soft tissue injury pain    Download Fulltext
The First Affiliated Hospital of Chongqing Medical University, 400016
Fund Project:
Abstract:
      Abstract Objective: To evaluate the effect, safety and long-term result of low intensity focused ultrasound towards chronic soft tissue injury. Method: One hundred and twenty patients were randomized to a treatment group (TG) or a control group (CG). All patients took the same medicine. The TG group received a series of low intensity focused ultrasound treatments over a period of 5d; while the CG group received sham treatments. Self-report outcomes were measured before and 10min, 15min, 30min, 24h after the treatments with NRS (numeric rating scale) scores. Adverse reactions of both groups and the onset time of TG were recorded too. In addition, follow up evaluation (1 month, 3 months, 6 months after the last treatment) included the NRS scores, number of people who had function impairment or readmission, and amount of medicine needed. Result: The onset time of TG increased gradually from (43.76±19.01)s to (101.50±30.35)s (P<0.05). The NRS scores of TG and CG decreased respectively from (5.28±1.02) to (1.02±0.92), (5.49±1.02) to (3.27±0.92) after treatments, there were significant differences in both groups. In general the patients of TG had significantly less pain after treatment than patients of CG in most times (P<0.05). NRS scores revealed that pain decreased gradually in TG after the 5th treatment than the former treatment (P<0.05). Within group comparisons, 30min after treatment the most reduction of pain was observed, while 24h after treatment, NRS scores decreased fewer than other times, the difference had statistical significance (P<0.05). None of the groups reported any adverse reaction. With long-term follow-up, the number of people who had dysfunction, took analgesic and readmission increased with time extension(P<0.05). Conclusion: Low intensity focused ultrasound treatment combined with medicine appeared to be more effective in relieving chronic pain than single drugs, safety were guaranteed in both groups. The effect of 5 times low intensity focused ultrasound treatment was better than one time treatment. In a single course of treatment, 30min after treatment showed the best effect, but 24h after treatment the effect declined obviously. Long-term effect of focused ultrasound should be remain to further search and improve.
Keywords:focused ultrasound  chronic soft tissue injury  effect  long term outcome
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