目的:触发指(TF)是一种常见的手部疾病,可以通过手术治疗。我们进行了系统评价和荟萃分析,以评估超声引导(US引导)经皮手术是否优于其他常规手术方法。
方法:我们在Medline进行了全面搜索,Embase,和Cochrane图书馆来确定相关研究。我们纳入了随机临床试验(RCT)和观察性研究,比较了美国指导的TF释放与盲经皮或开放入路。我们将风险比(RR)和平均差异(MD)与95%置信区间(CI)相结合。采用R软件进行数据处理和分析,版本4.3.1。
结果:我们的分析包括8项RCT和2项观察性研究,共555例患者。US引导手术显著降低术后DASH评分(MD-3.75分;95%CI=-7.48,-0.02;p<0.01),恢复活动时间缩短(MD-11.52天;95%CI=-16.13,-6.91;p<0.01),迅速停止口服镇痛药(MD-4.44天;95%CI=-8.01,-0.87;p<0.01),改善患者满意度评分(RR1.13;95%CI=1.04,1.23;p=0.75)。VAS评分无显著差异,运动恢复的时间,或手术成功率。
结论:超声引导经皮释放是一种安全的,有效,与其他方法相比,治疗TF的优势在于,提高了DASH分数,更快的恢复,更快地停止口服镇痛药,提高患者满意度。
OBJECTIVE: Trigger finger (TF) is a common hand condition that can be treated with surgery. We conducted a systematic review and meta-analysis to assess whether ultrasound-guided (US-guided) percutaneous surgery is superior to other conventional surgical methods.
METHODS: We conducted a comprehensive search in Medline, Embase, and the Cochrane Library to identify relevant studies. We included randomized clinical trials (RCTs) and observational studies comparing US-guided TF release with blind percutaneous or open approaches. We combined Risk Ratios (RR) and Mean Differences (MD) with 95% Confidence Intervals (CI) across studies. Data processing and analysis were conducted using R software, version 4.3.1.
RESULTS: Our analysis included eight RCTs and two observational studies with 555 patients. US-guided surgery significantly reduced postoperative DASH scores (MD -3.75 points; 95% CI = -7.48, -0.02; p < 0.01), shortened time to resume activities (MD -11.52 days; 95% CI = -16.13, -6.91; p < 0.01), hastened discontinuation of oral analgesics (MD -4.44 days; 95% CI = -8.01, -0.87; p < 0.01), and improved patient satisfaction scores (RR 1.13; 95% CI = 1.04, 1.23; p = 0.75). There were no significant differences in VAS scores, time to movement recovery, or surgical success rate.
CONCLUSIONS: Ultrasound-guided percutaneous release is a safe, effective, and superior alternative for treating TF compared to other methods, leading to improved DASH scores, quicker recovery, faster cessation of oral analgesics, and enhanced patient satisfaction.