探讨超声引导下四肢浅表软组织血肿清除术的应用价值。

选取2019年2月至2020年12月于湖州市中医院就诊的四肢浅表软组织血肿病例29例。所有患者均行超声引导下血肿清除术。对患者术前、术后1周及术后1个月进行超声检查，计算血肿体积减小率及减压效果，并对术后并发症及术前与术后的数字评定量表（NRS）评分进行比较分析。

术前超声示血肿体积为6.0~109.4 ml（中位数16.2 ml），术后1周血肿体积缩小至0.8~15.9 ml（中位数4.7 ml），体积减小率平均为（73.8±10.2）%，其中55.2%（16/29）为中度减压，44.8%（13/29）为完全减压，10.3%（3/29）达临床治愈。术后1个月血肿体积较术前进一步减小，体积减小率平均为（95.5±3.5）%，所有患者均获完全减压，其中93.1%（27/29）达临床治愈。术前NRS疼痛评分平均为（3.5±1.5）分，术后即刻为0~3分（中位数1分），术后1个月为0~1分（中位数0分）。术后1个月内部分患者出现肢体轻微麻木感（13.8%）、患肢肿胀感（20.7%），术后1个月后上述症状均明显减轻或完全消失。所有患者均未出现感染及皮肤坏死、患肢深静脉血栓等并发症。

高频超声引导下血肿清除术是一种安全有效的治疗方式，是对现行治疗方法的有效补充，具有良好的临床应用前景。

To assess the application value of high-frequency ultrasound in the evacuation of superficial soft tissue hematomas of the extremities.

Twenty-nine patients with superficial soft tissue hematoma of the extremities who were treated at Huzhou T.C.M Hospital from February 2019 to December 2020 were analyzed. All patients underwent ultrasound-guided hematoma evacuation. The patients underwent ultrasonography before surgery, 1 week after surgery, and 1 month after surgery, and then the rate of hematoma volume reduction was calculated.The surgical decompression effect, postoperative complications, and preoperative and postoperative numerical rating scale (NRS) pain scores were analyzed.

Preoperative ultrasound showed that the hematoma volume ranged from 6~109.4 ml (median, 16.2 ml), and the hematoma volume decreased to 0.8~15.9 ml (median, 4.7 ml) 1 week after the operation. The average volume reduction rate was (73.8±10.2)%; 55.2% (16/29) achieved moderate decompression, 44.8% (13/29) achieved complete decompression, and 10.3% (3/29) achieved clinical cure. One month after operation, the hematoma volume was further reduced compared with that before operation, with an average volume reduction rate of (95.5±3.5) %. All patients were completely decompressed, and 93.1% (27/29) of them were clinically cured. The average NRS pain scores were (3.5±1.5) points preoperatively, 0-3 points (median, 1 point) immediately after operation, and 0-1 points (median 0 points) 1 month after operation. Some patients experienced slight numbness of the limbs (13.8%) and swelling of affected limbs (20.7%) within 1 month after operation, and the above symptoms were significantly relieved or completely disappeared 1 month after operation. There were no complications such as infection, skin necrosis, and deep vein thrombosis of affected limbs in all patients.

Hematoma evacuation under the guidance of high frequency ultrasound is a safe and effective treatment method, which is an effective supplement to the current treatment methods and has a good clinical application prospect.