桡骨茎突狭窄性腱鞘炎 - 诊断与治疗 - 妙佑医疗国际

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桡骨茎突狭窄性腱鞘炎

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诊断

为了诊断桡骨茎突狭窄性腱鞘炎，医生会检查您的手部，以查看拇指一侧的手腕在受到压迫时是否会感到疼痛。医生也会进行芬克尔斯坦测试，即让您把拇指弯曲到手掌上，其余四指弯曲到拇指上。然后向小指方向弯曲手腕。如果这样做会导致拇指一侧的手腕疼痛，则您可能就患有桡骨茎突狭窄性腱鞘炎。诊断桡骨茎突狭窄性腱鞘炎时通常无需进行 X 线等影像学检查。

Tests

You may be asked to perform a Finkelstein test, in which you bend your thumb across the palm of your hand and bend your fingers down over your thumb. Then you bend your wrist toward your little finger. If this causes pain on the thumb side of your wrist, you likely have de Quervain tenosynovitis. Imaging tests, such as X-rays, generally aren't needed to diagnose de Quervain tenosynovitis.

治疗

桡骨茎突狭窄性腱鞘炎的治疗旨在减轻炎症，保持拇指运动并防止复发。如果您提早开始治疗，则症状应在四到六周内改善。如果您的桡骨茎突狭窄性腱鞘炎始于怀孕期间，则症状可能会在孕期或哺乳期结束时消失。

药物治疗

为了减轻疼痛和肿胀，您的医生可能建议使用非处方止痛药，例如布洛芬（Advil、Motrin IB 等）和萘普生 (Aleve)。医生可能还会建议在腱鞘内注射皮质类固醇药物以减少肿胀。如果在出现症状的头六个月内开始治疗，大多数人通常在注射一次皮质类固醇激素后即可完全康复。

治疗

桡骨茎突狭窄性腱鞘炎的初步治疗可能包括：固定您的拇指和手腕，用夹板或支架使其保持笔直，以帮助肌腱休息尽可能避免重复的拇指运动左右移动手腕时避免捏拇指冷敷患处您可能还会去看理疗师或职业治疗师。这些治疗师可能会审查您的手腕使用方式，并就如何进行调整以减轻手腕压力提出建议。您的治疗师还可以教您锻炼手腕、手和手臂，以增强肌肉、减轻疼痛和对肌腱的刺激。

外科手术

如果您的病情更严重，医生可能会建议您进行门诊手术。手术中的一项程序是让您的医生检查包裹受累肌腱的腱鞘，然后打开腱鞘以释放压力，以便肌腱可以自由滑动。医生将与您讨论手术后如何休息、增强和恢复身体。理疗师或职业治疗师可能会在手术后与您会面、以教您新的增力训练方法，并帮助您调整日常生活，以防患于未然。

Medications

To reduce pain and swelling, your doctor may recommend using pain relievers that you can buy without a prescription. These include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Your doctor may also recommend injections of corticosteroid medications into the tendon covering to reduce swelling. If treatment begins within the first six months of symptoms, most people recover completely after receiving corticosteroid injections, often after just one injection.

Therapies

Initial treatment of de Quervain tenosynovitis may include: Immobilizing the thumb and wrist, keeping them straight with a splint or brace to help rest the tendons Avoiding repetitive thumb movements as much as possible Avoiding pinching with the thumb when moving the wrist from side to side Applying ice to the affected area You may also see a physical therapist or an occupational therapist. The therapist may review how you use your wrist and give suggestions on how to relieve stress on your wrists. Your therapist can also teach you exercises for your wrist, hand and arm. These exercises can strengthen your muscles, reduce pain and limit tendon irritation.

Surgery or other procedures

Surgery may be recommended for more-serious cases. The surgery is outpatient. In the procedure, the surgeon inspects the sheath surrounding the involved tendon or tendons and then opens the sheath to release the pressure. This allows the tendons to glide freely. Your health care provider will talk to you about how to rest, strengthen and rehabilitate your body after surgery. A physical therapist or an occupational therapist may meet with you after surgery to teach you new strengthening exercises and help you adjust your daily routine to prevent future problems. 申请 Mayo Clinic 预约

生活方式与家庭疗法

如果您不需要手术，则此病症的治疗与预防方法大致相同：避免重复相同的腕部动作。根据医生建议，请佩戴支架或夹板。坚持推荐的运动。注意引起拇指和腕部疼痛、肿胀或麻木的活动，尽量避免这些活动，并与医生分享这些信息。

准备您的预约

如果您的手部或者腕部疼痛，且自我护理方法（比如避免诱发疼痛的活动）无效，请与医生约诊。在经过初步检查后，您的医生可能会将您转诊至骨科医生、风湿科医生、手部治疗师或职业治疗师。以下信息可以帮助您做好就诊准备。

您可以做什么

写下关键医疗信息，包括您患有的其他疾病和正在服用的所有药品和补充剂。记录可能使您的手部或腕部劳损的爱好和活动，比如编织、园艺、演奏乐器、参加挥拍类运动，或者进行重复性的工作场所活动。记录最近手部或腕部发生的损伤。写下要向医生咨询的问题。下面列出了当就医评估腕部或手部相关症状时可向医生咨询的一些基本问题。导致我出现症状的最可能原因是什么？还有其他可能的原因吗？我是否需要检查来确认诊断？您建议哪种治疗方法？我还有其他健康问题。我怎样才能最好地同时管理这些状况？我需要手术吗？我需要多久不能参加可能引发该疾病的活动？我自己还可以做些什么来改善状况？如果还有其他问题，您也可以随时提出。

医生可能做些什么

医生可能会问您一些问题，包括：您有哪些症状，这些症状何时开始出现？您的症状是出现恶化还是保持不变？什么活动会引发您的症状？您是否有一些需要进行重复性手部或腕部动作的爱好或者进行相关的运动？您在工作中需要执行哪些任务？您最近有没有发生可能导致手部或腕部受伤的损伤？避免进行引起您症状的活动是否能缓解症状？您是否尝试过居家治疗，比如使用非处方止痛药？哪些会有助于缓解症状？

What you can do

Write down key medical information, including other conditions you have and all medications and supplements you're taking. Note hobbies and activities that may strain your hand or wrist, such as knitting, gardening, playing an instrument, participating in racket sports or performing repetitive workplace activities. Note any recent injuries to your hand or wrist. Write down questions to ask your doctor. Below are some basic questions to ask the health care provider who evaluates you for wrist- or hand-related symptoms. What is the most likely cause of my symptoms? Are there other possible causes? Do I need tests to confirm the diagnosis? What treatment do you recommend? I have other health problems. How can I best manage these conditions together? Will I need surgery? How long will I need to avoid the activities that caused my condition? What else can I do on my own to improve my condition? Don't hesitate to ask other questions as well.

What to expect from your doctor

A health care provider who sees you for symptoms common to de Quervain tenosynovitis may ask a number of questions. You might be asked: What are your symptoms and when did they begin? Have your symptoms been getting worse or staying the same? What activities seem to trigger your symptoms? Do you participate in any hobbies or sports that involve repetitive hand or wrist movements? What tasks do you perform at work? Have you recently had an injury that may have damaged your hand or wrist? Does it help to avoid the activities that trigger your symptoms? Have you tried at-home treatments, such as nonprescription pain relievers? What, if anything, helps? 来自妙佑医疗国际员工申请 Mayo Clinic 预约症状与病因医生与科室 July 02, 2022 打印显示参考文献 De Quervain's tendinitis (De Quervain's tendinosis). American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00007. Accessed April 30, 2015. Anderson BC, et al. de Quervain's tenosynovitis. http://www.uptodate.com/home. Accessed April 30, 2015. de Quervain syndrome. American Society for Surgery of the Hand. http://www.assh.org/handcare/hand-arm-conditions/de-quervain-syndrome. Accessed April 30, 2015. Peters-Veluthamaningal C, et al. Corticosteroid injection for de Quervain's tenosynovitis. Cochrane Database of Systematic Reviews. http://ovidsp.tx.ovid.com/sp-3.15.1b/ovidweb.cgi?&S=MDMIFPOGBPDDNLCMNCKKHEMCBFIFAA00&Link+Set=S.sh.181sl_50. April 30, 2015. Goel R, et al. de Quervain's tenosynovitis: a review of the rehabilitative options. Hand. 2015;10:1.