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| 探切刀微创松解与开放手术治疗扳机指的疗效分析 |
| A clinical trial comparing ultrasound-guided minimally invasive release with a novel probing-cutting knife versus open surgery for trigger digit |
| 投稿时间：2026-01-31 |
| DOI：10.3969/j.issn.1000-0399.2026.08.008 |
| 中文关键词: 扳机指 腱鞘炎 手术松解 微创外科手术 |
| 英文关键词: Trigger digit Tenosynovitis Surgical release Minimally invasive surgical procedures |
| 基金项目:2023年度亳州市卫生健康科研项目(编号:bzwj2023c002) |
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| 中文摘要: |
| 目的 比较自研工具（探切刀）微创松解与开放手术治疗扳机指的临床效果。方法 回顾性分析2024年1月至2025年6月亳州市中医院收治的49例扳机指患者临床资料，其中，超声引导下探切刀微创松解治疗24例（探切刀组），开放手术治疗25例（开放手术组）。比较两组手术时间、术后并发症发生率、患指功能恢复时间、疼痛视觉模拟评分（VAS）、快速臂肩手残疾（Quick DASH）评分和治疗效果差异。结果 探切刀组和开放手术组的手术时间、术后并发症发生率和治疗效果比较，差异无统计学意义（P>0.05）。探切刀组患指功能恢复时间早于开放手术组，差异有统计学意义（P<0.05）。重复测量方差分析显示，两组患者VAS和QD评分比较差异有统计学意义(VAS评分，F组间=5.989,P=0.018;Quick DASH评分，F组间=14.149,P<0.001)；两组患者术后不同时间点VAS和QD评分比较，差异有统计学意义(VAS评分，F时间=623.425,P<0.001;Quick DASH评分，F时间=759.118,P<0.001)且不同术式和时间有交互作用(VAS评分，F交互=3.870,P=0.009;Quick DASH评分，F交互=4.560,P=0.002)。术后第1、2、3周探切刀组VAS和Quick DASH评分低于开放手术组，差异有统计学意义（Bonferroni校正，P’<0.008）；术后第4、8周和第24周两组患者VAS和Quick DASH评分比较，差异无统计学意义（P’>0.008）。结论 超声引导下探切刀微创松解和开放手术治疗扳机指均能获得较好临床效果，相较于开放手术，超声引导下探切刀微创松解有利于手功能的更早恢复。 |
| 英文摘要: |
| Objective To compare the clinical effects of minimally invasive release using a self-developed instrument（probing-cutting knife） versus open surgery in the treatment of trigger digit. Methods A retrospective analysis was conducted on the data of patients with trigger digits treated at Bozhou Traditional Chinese Medicine Hospital from January 2024 to June 2025, among whom 24 patients received minimally invasive release with the probing-cutting knife（probing-cutting knife group,PKG） and 25 patients underwent open surgery（open surgery group,OSG）. The operation duration, incidence of postoperative complications, functional recovery time of affected fingers, Visual Analogue Scale（VAS） score, Quick Disabilities of the Arm, Shoulder and Hand（Quick DASH） score, and clinical effects were observed. Results There were no statistically significant differences in operation duration, incidence of postoperative complications and clinical effects between PKG and OSG（P>0.05）. The functional recovery time of affected fingers in PKG was earlier than that in OSG, with statistically significant difference（P<0.05）. Repeated-measures analysis of variance（Bonferroni correction） showed that There were statistically significant differences in VAS and Quick-DASH scores between the two groups(VAS score: Fgroup=5.989, P=0.018; Quick-DASH score: Fgroup=14.149, P<0.001). Statistically significant differences were observed in VAS and Quick-DASH scores at different postoperative time points for both groups(VAS score: Ftime=623.425, P<0.001; Quick-DASH score: Ftime=759.118, P<0.001), and there was an interaction between surgical approach and time(VAS score: Finteraction=3.870, P=0.009; Quick-DASH score: Finteraction=4.560, P=0.002).The VAS and Quick DASH scores in PKG were significantly lower than those in OSG at the 1 st, 2 nd and 3 rd weeks after operation, with statistically significant differences（P'<0.008）; there were no statistically significant differences in VAS and Quick DASH scores between the two groups at the 4 th, 8 th and 24 th weeks after operation（P'>0.008）. Conclusion Both ultrasound-guided minimally invasive release with probe-cutting knife and open surgery can achieve satisfactory clinical outcomes for trigger digit. Compared with open surgery, ultrasound-guided minimally invasive release using the probing-cutting knife facilitates earlier recovery of hand function. |
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