探讨超声引导下介入治疗跖筋膜炎的临床价值。

2011年8月至2014年8月在四川省人民医院经临床及超声诊断而保守治疗效果不佳的38例跖筋膜炎患者，采用随机数字表法将38例患者随机分为试验组和对照组，试验组进行超声引导下介入治疗，对照组进行传统封闭治疗，分别于注射类固醇激素治疗前、治疗后4周和12周行足底疼痛评分（采用视觉模拟评分法，VAS评分）和超声检查，并进行对比分析。

2组患者治疗后VAS评分及跖筋膜厚度均较治疗前明显改善（P均<0.01）。治疗后4周，试验组VAS评分及跖筋膜厚度与对照组比较，差异均无统计学意义[2.52±0.77 vs 2.68±0.82，P>0.05；（4.56±0.25）mm vs （4.72±0.38）mm，P>0.05]。治疗后12周，试验组VAS评分较对照组降低，差异有统计学意义（1.47±0.77 vs 2.37±0.68，P<0.01）；试验组跖筋膜厚度较对照组变薄，差异有统计学意义[（4.02±0.24）mm vs （4.53±0.35）mm，P<0.01]。治疗后12周，试验组跖筋膜内钙化灶较治疗前消失或减少。

超声引导下介入治疗跖筋膜炎较传统封闭治疗更准确有效，具有重要的临床价值。

To detect the value of ultrasound-guided steroids injection for the treatment of plantar fasciitis.

Thirty-eight physical therapy ineffective plantar fasciitis patients were enrolled in this study, and randomly divided into ultrasound-guided and palpation-guided groups. Pain intensity was measured using a visual analog scale (VAS) and plantar fasciitis were evaluated by high frequency ultrasound including assessment of the thickness before injection and at 4 weeks, 12 weeks post injection.

Thirty-eight patients who received either ultrasound guided or palpation-guided injection had significantly lower visual analog scale scores and lower plantar fascia thickness (both P<0.01) at 4 weeks, 12 weeks post injection. The differences in plantar fascia thickness, VAS score between the two groups before, and at the 4 weeks follow-up were not statistically significant [2.52±0.77 vs 2.68±0.82, P>0.05; (4.56±0.25)?mm vs (4.72±0.38)?mm, P>0.05]. However, the ultrasound guided group had lower mean visual analog scale score (1.47±0.77 vs 2.37±0.68, P<0.01) and lower mean plantar fascia thickness [(4.02±0.24)?mm vs (4.53±0.35)?mm, P<0.01] than the palpation-guided group at 12 weeks post injection. The calcification of the plantar fascia at 12 weeks post injection in ultrasound guided group was completely disappeared or significantly decreased.

Ultrasound-guided injection for treating plantar fasciitis is more accurate and effective than palpation-guided injection, and is of great clinical value for both patients and doctors.