目的 评价依托芬那酯凝胶治疗腱鞘炎在超声引导下微创术后肿痛的有效性和安全性。 方法 采用随机、对照的设计，将2011年5月－2012年7月，在四川省人民医院门诊接受腱鞘炎超声引导微创术后的患者157例，分为两组，治疗组（n=81）采用依托芬那酯凝胶外用，对照组（n=76）不使用外用药物。 结果 两组治疗后24 h及3 d的疼痛评分、压痛及关节功能缓解率与治疗前自身比较及组间比较，差别均有统计学意义（P＜0.05），7 d时治疗组临床总有效率为90.12%，对照组为89.47%，组间比较无统计学意义（P＞0.05），治疗组在使用应急药物上明显优于对照组。两组安全性评价比较差异无统计学意义（P＞0.05）。 结论 依托芬那酯凝胶能快速、有效、安全地缓解腱鞘炎超声引导微创术后局部肿胀疼痛的症状。
Objective To investigate the therapeutic effect of minimally invasive small incision surgery under local anesthesia for pediatric stenosing tenovaginitis of thumb. Methods A retrospective analysis was conducted on the medical records of children with stenosing tenovaginitis of thumb who received small incision tendinolysis under local anesthesia at West China Hospital of Sichuan University between January 2013 and August 2022, to evaluate and analyze the safety and effectiveness of the surgery. Results A total of 949 pediatric patients were included, with an average age of (3.23±1.92) years. The average duration of surgery was (7.0±2.5) minutes, and the average follow-up time was (3.91±5.32) months. All patients did not need to fast for solids and liquids before surgery, and were immediately discharged from the hospital after outpatient surgery. The family members of the patients were highly satisfied with the treatment process and postoperative recovery. All patients had no nerve or vascular damage, and the wound margin skin showed linear healing with mild scars that fused with palm prints. There were 825 cases (86.93%) of children with thumb function fully restored to normal, 113 cases (11.91%) with limited maximum dorsiflexion function of the thumb, and 11 cases (1.16%) with recurrent stiffness of the thumb metacarpophalangeal joint. Conclusion Small incision tendinolysis under local anesthesia is a safe and effective treatment for pediatric stenosing tenovaginitis of thumb, with high satisfaction among the patients’ family members.