影像技术

目的：探究体外冲击波治疗膝关节炎对肌骨超声软组织参数的影响。方法：选取庆阳市中医医院在2024年1月至12月收治的164例膝关节炎患者为研究对象，以1∶1随机配对方式将患者分成对照组与观察组，对照组采用塞来昔布治疗，观察组在塞来昔布用药的同时给予体外冲击波疗法。运用PHILIPS EPIQ7彩色多普勒超声诊断仪检测肌骨超声软组织参数，对比两组治疗效果、膝关节功能、疼痛程度、炎性因子水平、超声指标和不良反应发生率。结果：在治疗8周后，观察组的总有效率98.78%显著高于对照组的总有效率87.80%(P<0.05)。治疗后，观察组WOMAC指数、疼痛程度低于对照组，膝关节活动度更高（P<0.05）；且治疗8周后关节液中的炎性因子（IL-1、TNF-α、MMP-13）水平比较，观察组均较对照组更低（P<0.05）。治疗后观察组的膝关节周径、腔积液、滑膜厚度小于对照组，关节软骨厚度大于对照组（P<0.05）。两组不良反应发生率无显著差异（P>0.05）。结论：体外冲击波治疗膝关节炎效果显著，能减轻疼痛、改善膝关节功能与活动度，且不良反应少。肌骨超声显示患者膝关节软组织改善，该治疗方案具有重要临床应用价值。

Objective: To investigate the effect of extracorporeal shock wave therapy on musculoskeletal ultrasound soft tissue parameters in knee arthritis. Methods: 164 patients with knee arthritis admitted to Qingyang Traditional Chinese Medicine Hospital from January to December 2024 were selected as the subjects. The patients were randomly matched in a 1∶1 ratio and divided into a control group and an observation group. The control group was treated with celecoxib, while the observation group was treated with extracorporeal shock wave therapy in addition to celecoxib. PHILIPS EPIQ7 color Doppler ultrasound diagnostic instrument was used to detect musculoskeletal ultrasound soft tissue parameters, compare the treatment effects, knee joint function, pain level, inflammatory factor levels, ultrasound indicators, and incidence of adverse reactions between two groups. Results: After 8 weeks of treatment, the total effective rate of the observation group was 98.78%, significantly higher than the total effective rate of the control group, which was 87.80%(P<0.05). After treatment, the WOMAC index and pain level of the observation group were lower than those of the control group, and the knee joint mobility was higher(P<0.05). After 8 weeks of treatment, the levels of inflammatory factors(IL-1, TNF-α, MMP-13) in the joint fluid of the observation group were lower than those of the control group(P<0.05). After treatment, the knee joint circumference, fluid accumulation, and synovial thickness of the observation group were smaller than those of the control group, while the joint cartilage thickness was greater than that of the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Extracorporeal shock wave therapy has significant effects on knee arthritis, reducing pain, improving knee joint function and range of motion, and has fewer adverse reactions.Musculoskeletal ultrasound shows improvement in the soft tissue of the patient's knee joint, and this treatment plan has important clinical application value.