足底筋膜是由厚的、纵向交织的结缔组织紧贴足底皮肤形成的,起始于内侧跟骨结节,向前形成5个分支连接每个脚趾.足底筋膜炎是足跟痛的常见原因,其发病率约为10%[1].病理学检查证实足底筋膜炎实际是足底筋膜的一种退行性、非感染性炎性改变[2].生活方式或运动造成的过度负重,可使跟骨的肌肉附着点出现急性或慢性的无菌性炎性改变[3].足底筋膜炎一般会引起足跟部的剧烈疼痛,这种疼痛通常是在早晨刚起床或长时间坐位后足部着地时出现[4].临床上,足底筋膜炎的治疗方法包括:矫形鞋垫、肌内效贴、牵伸技术、冲击波、类固醇注射等[5],其中后两种方法在临床较为常用,本研究观察比较了这两种方法治疗足底筋膜炎的疗效.报告如下.

目的 探讨低强度聚焦超声联合低能量激光治疗足底筋膜炎的疗效.方法 2014年8月-2015年8月我科收治足底筋膜炎患者66例,用简单随机分组方法分为治疗组(n=33)和对照组(n=33),治疗组采用低能量激光照射和低强度聚焦超声治疗,对照组采用低能量激光照射,治疗3个疗程,随访2个月,比较两组的视觉模拟评分(visual analogue scale,VAS)和有效率.结果 所有患者获得随访,无症状反复.治疗后,治疗组和对照组的VAS评分均显著低于治疗前(8.2±1.1 vs1.7±0.9,8.1±1.0 vs 2.3±1.2,P＜0.05);治疗后,治疗组VAS评分明显低于对照组(1.7±0.9 vs 2.3±1.2,P＜0.05).治疗组有效率为96.97％,对照组有效率为87.88％,差异有统计学意义(P＜0.05).结论 低强度聚焦超声联合低能量激光治疗足底筋膜炎效果良好,值得临床推广.

Objective To observe the effect of ultraviolet C combined with low-level laser therapy in promoting rapid healing of infected wounds and sinus after colon-cancer surgery.Methods The patient was a 48-year-old male with sigmoid colon ulcer type differentiated adenocarcinoma. A sinus about 3 cm was found at the end part of operation incision after 3 weeks of laparoscopic radical resection of sigmoid colon cancer. Debridement treatment was repeated many times, but the sinus was still difficult to heal. Then the patient was transferred to our department. Ultraviolet C combined with laser radiation therapy was chosen. Firstly, iodophor alcohol was used to clean the wound and sinus. Secondly, low-level laser radiated the wound and sinus with the band of 660nm, the waveform of DC wave and the total power of 360 HW. Thirdly, the ultraviolet C irradiated the inside part of the sinus, the wound surface and inflamed parts for once a day, a total of seven days.Results After seven days of light treatment, the sinus healed rapidly, the ulcer site were all cured with scabs, and the red swelling area reduced significantly.Conclusion Ultraviolet C combined with low-level laser therapy can effectively promote healing of wounds and sinus after colon-cancer surgery.