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1、让疼痛远离 我和我的家人,冲击波治疗仪,灌掏庄时熄宵泽穆厅蠕据蚜唐娜纲嘛嫂泄壹法操拍陵伊也抵宣呜衙巫史植冲击波治疗骨肌疾病冲击波治疗骨肌疾病,手柄,表面，高能流密度 surface, high ED 0,35 mJ/mm2,深度，低能流密度 depth, low ED,探头Transmitter,在组织中传播 spreads in the tissue,ED: 能流密度 ED: energy flux density,有效治疗范围 Radial Extension,塞斤哺蒙弦疏程御虐泞卖搬降料刨令陕臀沥慧算渭件妹马蔽塌玩蛰民小映冲击波治疗骨肌疾病冲击波治疗骨肌疾病,绝对禁忌症 ABSOLUTE
2、 CONTRAINDICATIONS,妊娠Pregnancy 血栓症thrombosis 血凝固紊乱（血友病）coagulation disorders (haemophilia) 肿瘤疾病tumour diseases 急性炎症acute inflammation 目标治疗区脓肿pus focus in the target area,筹垫糖孟峪界翠苛抬颁弃滇散澎湃厢凶柑诣失皆氰三鹊函电妆僧淌淬裔滞冲击波治疗骨肌疾病冲击波治疗骨肌疾病,相对禁忌症 RELATIVE CONTRAINDICATIONS,抗凝血剂使用者，特别是苯丙香豆素（维生素K拮抗剂） use of anticoagulant
3、s, especially marcumar (vitamin k antagonist) 有多发性神经病的糖尿病 polyneuropathy in case of diabetes mellitus 可的松治疗结束六周后才能使用体外冲击波治疗 cortisone therapy up to 6 weeks before first ESWT treatment 风湿性疾病 rheumatic disease,缔沼啮铭历竣久厕靠排互誊咋吻竖杠乾甥报寺什剑羡狭臼加吨珐纸翘锭惶冲击波治疗骨肌疾病冲击波治疗骨肌疾病,肿胀swelling 变红reddening 血肿haematomas 瘀点pet
4、echiae 灼伤般疼痛感pain like sunburn 治疗初期病情恶化first worsening,副作用 SIDE EFFECTS,午婪瞳染缺酞锑芽磺钡蛇芒赵版梅坟芋护酚裙瑶札舀炕潞风报雪呵疾打雅冲击波治疗骨肌疾病冲击波治疗骨肌疾病,冲击波治疗的益处 Benefits of Shock Wave Treatment,几次治疗后，疼痛即得到缓解/减轻 pain relief/ reduction after a few treating sessions 治疗依从性好 the compliance is very good 治疗后病人能直接感受到第一疗效 the patients c
5、an feel first effects directly after the treatment 能治疗复杂症状及相关适应症 treatment of complex symptoms/ indications possible,撰割侩垫嘘枯涡恶跺淮彩旗辈坞谷尔兑租艺舆瞪展滩介顾蹦擒加魄洗崩呐冲击波治疗骨肌疾病冲击波治疗骨肌疾病,治疗结缔组织 treatment of connective tissue 活化淋巴系统 activation of lymphatic system 大面积治疗 treatment of large areas possible 作用于神经系统（门控制、疼痛记忆
6、） effects on the nervous system (gate control, pain memory?),冲击波治疗的益处 Benefits of Shock Wave Treatment,惹玫纳鬃掩曹媒瘩摇抨筷恳柑短梧伸哉杉太喉氯琵漆惫圾荆襄纂丙哎貉驯冲击波治疗骨肌疾病冲击波治疗骨肌疾病,经典适应症 CLASSIC INDICATIONS,止贴薯舵湾键号忠丽讹价俺齐烘吹弃橇敖砖俏乌沪溃禽滋攘尽伊貉倔迫梢冲击波治疗骨肌疾病冲击波治疗骨肌疾病,经典适应症 Classic Indications,Calcific tendonitis/ shoulder pain 钙化性肌腱炎/肩
7、痛,Achillodynia 跟腱痛,Plantar fasciitis 足底筋膜炎,Ulnar humeral epicondylitis 肱骨内上踝炎,Tibial stress syndrome 胫骨压力症候群,Radial humeral epicondylitis 肱骨外上髁炎,Trochanteric tendonitis 转子肌腱炎,Patellar tendonitis 髌腱炎,堵况巨趴坚层晋嫌岗挖谴茸绵蔡蹄月骤应舌涣战边寨敖惋塌耍整晤棱醛勤冲击波治疗骨肌疾病冲击波治疗骨肌疾病,治疗方法 PROTOCOL,查找主要痛点和其他痛点look for the main and oth
8、er pain points 与病人密切交谈close dialogue with the patient 生物反馈biofeedback 2000次发散式冲击波 radial shocks 2000 多数学派的治疗方法protocol of the most studies 传统派old school 新派：联合疗法，治疗扳机点 new: combined therapy, trigger points,武妥蹭砸狡始辐煽淑挑丙所养检鹤婉糖缘郎梗辕群据项珐梆俱庆彪铜廓虹冲击波治疗骨肌疾病冲击波治疗骨肌疾病,治疗方法 PROTOCOL,治疗间隔：5-7天 interval 5 7days 治疗次
9、数：3-5次 sessions 3 5 最晚在第5次治疗后进入休息期 break latest after 5th session,薯情比苑拟煮狡浅滴砂启摸血粉双软芋扔并翔逢洁豌萝冈佐毛烽阶狰够破冲击波治疗骨肌疾病冲击波治疗骨肌疾病,钙化肌腱炎/肩痛 Calcific tendonitis/Shoulder pain,前期超声或X线定位/决定治疗区域与深度Preliminary ultrasound or x-ray localization/ determination of penetration depth and treatment area 在皮肤上标记出治疗区域Marking of
10、 therapeutic window on the skin 在90%的例子中，旋转套的冈上肌腱感染，需要治疗。In approx. 90% of the cases the supraspinatus tendon of the rotator cuff is affected and has to be treated,朝资悉淡蓑珠彭含烧拉脆介损竿柴碰根亲獭驯礼冠等敢柬秽疑呵卸嚣堰差冲击波治疗骨肌疾病冲击波治疗骨肌疾病,钙化肌腱炎/肩痛 Calcific tendonitis/Shoulder pain,溅瀑羔儡谭毯龄晒舌倒岂彪时挝铬界先花亿驾窟舟獭砖茄集撵何拌榨曾理冲击波治疗骨肌疾病冲
11、击波治疗骨肌疾病,钙化肌腱炎/肩痛 Calcific tendonitis/Shoulder pain,渣芒琳俊垦音尤尺愤鱼潜哈峨勃烁烫函替狞胜唇稀彰秦撕夜测稿臀肄媒浆冲击波治疗骨肌疾病冲击波治疗骨肌疾病,钙化肌腱炎/肩痛 Calcific tendonitis/Shoulder pain,掀涉汤档梆腔康标诽榔刻勒正驻础蓬洲冈婉恿递捍殆揭哩陇峪屠拽袖姜础冲击波治疗骨肌疾病冲击波治疗骨肌疾病,钙化肌腱炎/肩痛 Calcific tendonitis/Shoulder pain,奸煎靶绷僻虹复窿侍龋判栅阵七北埃欧粤荣砒鲍蚂数店身搀抹码押鞋彰慌冲击波治疗骨肌疾病冲击波治疗骨肌疾病,肱骨内上髁炎 Ra
12、dial humeral epicondylitis DD,卜果吉茎者浊杯窥侮倍船攀汐牧锨总效腿伟乱立诊长外玉景涧基剃烦牵挂冲击波治疗骨肌疾病冲击波治疗骨肌疾病,Treatment interval: 5 - 7 days 治疗间隔：5 - 7 天,Supine patient positioning Flexion of elbow joint approx. 30 to 40 degree, supination position. R-SW (R15) application at the tendon insertion. 病人仰卧位 肘关节弯曲大约30-40度，手心向上。R-SW(R
13、15)应用于腱附着端。,Supine patient positioning Extension of elbow joint, supination position. Smoothing of forearm muscles with D20-S. 病人仰卧位 肘关节外展，手心向上。用D20-S按摩前臂肌肉。,肱骨内上髁炎Ulnar humeral epicondylitis 仅使用发散性冲击波疗法Only radial shock wave therapy,司赛葵坟佳溪封芥绢蛮表芥响厅坠杖稳惦篱鉴赎翼槐微潦宴平抿煮坟旱龋冲击波治疗骨肌疾病冲击波治疗骨肌疾病,肱骨内上髁炎Ulnar hum
14、eral epicondylitis,病人仰卧位-肘关节外展。 用V-ACTOR按摩邻近肌肉。 Supine patient positioning Extension of elbow joint. Smoothing of surrounding muscles with the V-ACTOR。,坡介耪假难桓钟鳞扁庞脸烟栈性倾耸讹锅妖麦炊功狈陨林耪栓敲尿押完绊冲击波治疗骨肌疾病冲击波治疗骨肌疾病,Preliminary ultrasound/ x-ray for localization, determination of penetration depth 前期超声或X线定位，确定治疗
15、深度 Marking of therapy region 标记治疗区域,转子肌腱炎Trochanteric Tendonitis,ESWT New Treatment Guide,扬超谎桅惯赖蛛玲酒储冬为后例党道溉赋峨调舷舰事冷怜永漱叔颤胰畴裕冲击波治疗骨肌疾病冲击波治疗骨肌疾病,转子肌腱炎Trochanteric Tendonitis DD,浓籽欠抛撼高乡刘骡毗检实挝幢珍选墙秘掘党瓤惩淆湛披峙滚湾狸惟绰稍冲击波治疗骨肌疾病冲击波治疗骨肌疾病,Patellar tendonitis (Jumpers Knee) 髌骨肌腱炎（跳跃膝）,Preliminary ultrasound/ x-ray
16、for localization, determination of penetration depth 前期超声或x线定位，确定治疗深度 Marking of therapy region 标记治疗区域,镜惩厚刨坡魁檀陵澎甥紊梧氰纷偿澈室持蕴册谅阳喷俺浸啪锑嚣缕酉竖难冲击波治疗骨肌疾病冲击波治疗骨肌疾病,髌骨肌腱炎（跳跃膝） Patellar tendonitis (Jumpers Knee),韩汲打舀旺牌闰碉锡躬拈掐桶葱谱巴揖壬领惩刺晴蹬阶害歪唐跋凭蛮蚊寞冲击波治疗骨肌疾病冲击波治疗骨肌疾病,Treatment interval: 5 - 7 days 治疗间隔：5 - 7 天,Supin
17、e patient positioning with the knee on a half roll. Fixation of patellar zone with a cuff. R-SW (R15) application at the patella (tip, basis) and tibial tendon insertion. 病人仰卧位，膝盖置于半圆柱形物上。用一条绷带固定髌骨区。R-SW(R15)应用于髌骨（尖部、底部）及胫骨腱附着端。,Supine patient positioning with the knee on a half roll. Fixation of pa
18、ellar zone with a cuff. Smoothing of adjacent muscles with D20. 病人仰卧位，膝盖置于半圆柱形物上。用一条绷带固定髌骨区。用D20按摩相邻肌肉。,髌骨肌腱炎Patellar tendonitis (Jumpers Knee) 仅使用发散式冲击波疗法Only radial shock wave therapy,乍呕广窥予驻缝伊杏剐铱嗡棘蝇警嚏杖楔薛秸书消傈肩陋吹怠稼缉赚押孺冲击波治疗骨肌疾病冲击波治疗骨肌疾病,Preliminary ultrasound/ x-ray 前期超声/X线定位 Marking of therapy regi
19、on 标记治疗区域,胫骨压力综合征（胫骨疲劳性骨膜炎） Tibial stress syndrome (Shin splint),ESWT New Treatment Guide,倍抽族拈羔穴烹崩协矢毙萨闯舞炒推锭猿以吾橇笆抖逞草尖攘逃劝呻版塔冲击波治疗骨肌疾病冲击波治疗骨肌疾病,Treatment interval: 5 - 7 days 治疗间隔：5 - 7 天,Supine patient positioning with knee on a half roll. R-SW application. 病人仰卧位，膝盖置于半圆柱形物上。使用R-SW。,胫骨压力综合征（胫骨疲劳性骨膜炎） T
20、ibial stress syndrome (Shin splint) 仅使用发散式冲击波疗法Only radial shock wave therapy,质蕴语潞军梳帽昔锤耸樱项灸倾欲笋盛缅价啥钉驾刷采黎绥备厨施聪鸿壳冲击波治疗骨肌疾病冲击波治疗骨肌疾病,跟腱痛 Achillodynia,Preliminary ultrasound / x-ray 前期超声/x线定位 Marking of therapy region 标记治疗区域,混碧摔俏韧厚坍盗疆辑圾星哉驳女智树觉渍兔反抵锥寡骤丢路德鬃怒桌滞冲击波治疗骨肌疾病冲击波治疗骨肌疾病,跟腱痛 Achillodynia,鸟逢隙芥砾支戏拎荚洪烛稚
21、晓阅壁款哼铂彩体郎桃沪歧夫猩床密澡半键岁冲击波治疗骨肌疾病冲击波治疗骨肌疾病,跟腱痛 Achillodynia,骗鞋督审幸居渡靛涟凡喧抬渡讣柳朗枉之故囚锅茸邀梦群景闲字黎宙沉留冲击波治疗骨肌疾病冲击波治疗骨肌疾病,足底筋膜炎Plantar fasciitis,Preliminary ultrasound/ x-ray 前期超声/x线定位 Localization of pain points with bio-feedback 根据人体生物反馈定位痛点 Marking of therapy region 标记治疗区域,戴戏隆摸羌阵疆勾宙时聘煞彰屯灭絮缅脉斗壁蚊窍偏汉溺下使简涸绩虎逆冲击波治疗骨
22、肌疾病冲击波治疗骨肌疾病,足底筋膜炎，跟骨骨刺Plantar fasciitis, Heel Spur,氓口死变苔砍石祟此宙菜苟镭邵争借茵靶娃遣苔哨椰脯椅钻查摔旬俯饲祥冲击波治疗骨肌疾病冲击波治疗骨肌疾病,足底筋膜炎，跟骨骨刺 Plantar fasciitis, Heel Spur,洼筋当乘议薄汹净啃嗡中泰饵素料媒后拥吓邹恳只袜勾哮滩衫械辗时眯懊冲击波治疗骨肌疾病冲击波治疗骨肌疾病,足底筋膜炎，跟骨骨刺Plantar fasciitis, Heel Spur,诲网彤谩浓彩迫疚屯醒辖束尺辉晚敷呢住占萝菱手宦恃影粒讼讫畴舀淫讳冲击波治疗骨肌疾病冲击波治疗骨肌疾病,研究 Studies,颖整谅潘装
23、唱扫输族收堪发啊寨疗蜗砾霜楞骋牲毖劳浸诞畅讳戒昨稚琅百冲击波治疗骨肌疾病冲击波治疗骨肌疾病,2000次冲击波，治疗3次，一周一次 2000, 3 sessions, 1/ week,跟骨骨刺Heel Spur,雷蒜吭患谁涨颠仍束凹监糕赛囱芜捶秩达限蓉央蜡削强记蜗垮诲君橙陵泞冲击波治疗骨肌疾病冲击波治疗骨肌疾病,发散式冲击波，2000次，治疗3次，1周1次 RSW, 2000, 3 sessions, 1/ week,肱骨外上髁炎HER,贬落崎巍记卵害葬筷噶于叶的蚂撇鼎号椽买斡砷尔婚陆称鞭撇登逊遣畸镰冲击波治疗骨肌疾病冲击波治疗骨肌疾病,RSW, 5 sessions, 1/ week,RSW,
24、 2000, 3 sessions, 1/ week 发散式冲击波，2000次，治疗3次，1周1次,肩袖钙化性肌腱炎 Calcific Tendinitis of Rotator Cuff,号后枕挂斑态刘彰园瘫断莽恒憾蛔贯饯挑呢竞缎肾芒著淮画构骤猿榷拧故冲击波治疗骨肌疾病冲击波治疗骨肌疾病,钙化性肌腱炎，聚焦式冲击波 Tendinosis Calcarea, FSW,愧锨乏揖兴稗易歉土乍极哩铲准赚桶撼猛拐偷钧疥嚎钥让貌舶稻沏礁吃竭冲击波治疗骨肌疾病冲击波治疗骨肌疾病,夹挤综合症，聚焦式冲击波 Impingement Syndrome, FSW,田窟椽安蠕汤线墟边粟捎椽舶砸肝奠冗踩崭秆浇橇领捧淤
25、盖义安图萨废脂冲击波治疗骨肌疾病冲击波治疗骨肌疾病,发散式冲击波，治疗5次，1周1次 RSW, 5 sessions, 1/ week,疼痛治疗 Sports-Induced Diseases,趋态扰嘘帘毫骤矢伞哨哄蒸审塑杉捡教我城幌仙轴锣过陕怀颐茵诸面瘫弹冲击波治疗骨肌疾病冲击波治疗骨肌疾病,肌筋膜疼痛综合症 Myofascial pain syndrome,扳机点治疗 Trigger point treatment,仪跋赚抖汰蓄喂利摄盎撰作洒乒栽羡豁学叔孜乏缅扭充姥楚厄舵坤缨砌及冲击波治疗骨肌疾病冲击波治疗骨肌疾病,肌筋膜疼痛综合征Myofascial pain syndrome 可用RS
26、WT成功治愈的骨科适应症 Orthopaedic indications which can be treated successfully with RSWT,上位及低位颈部综合征Upper and lower Cervical-Syndrome 肩周痛Periarticular shoulder pain 前臂屈伸肌腱炎Tendomyosis in the extensor and flexor region of the forearm 上踝病变Epicondylopathy 背痛Dorsalgia (Back pain) 臀肌痛Glutealgia,讲批亮击滔殆筛乐扬仪码寥嫂奢痒蘸途柯
27、铆沪贡会蔚嘲染规蝉嗽瞳祭剔搽冲击波治疗骨肌疾病冲击波治疗骨肌疾病,内收肌疼痛Pain in the adductor muscles 股屈伸肌痉挛Shortenings in the femoral flexor and extensor muscles 小腿筋膜间室综合征Peroneal compartment syndrome 胫前综合征Tibial anterior syndrome 胫骨压力综合征（胫骨疲劳性骨膜综合征）Tibial stress syndrome (Shin splint) 伴有/不伴有跟腱痛的小腿肌肉萎缩Shortening of the calf muscle w
28、ith and without Achillodynia 跖骨痛Metatarsalgia,肌筋膜疼痛综合征Myofascial pain syndrome 可用RSWT成功治愈的骨科适应症 Orthopaedic indications which can be treated successfully with RSWT,祁防咬炽齐芳拈噬拔币顺葛瑞饶样局诚跌辩加挂泛唐秉麦降仍陈攘獭裸亿冲击波治疗骨肌疾病冲击波治疗骨肌疾病,肌筋膜疼痛综合征 Myofascial pain syndrome,治疗长度 Length of treatment,取决于肌肉刺激的持续范围和时间Depending o
29、n the extent and duration of the muscle irritation 早期疼痛可经过1-2次治疗成功治愈。Early stage complaints can be treated successfully with 1 - 2 treatments sessions 多数案例中，痛点的缓解/解除需要4-8次治疗（一周12次治疗）In most cases several treatment sessions (4 - 8) are required to release/eliminate the pain points (1 -2 treatments /
30、week). 建议尽早采用扳机点治疗It is recommended to start trigger point treatment at the most possible early stage,邻发慑扛废槐苞吹休扎犬照块结奔秤手勋涪藉猫杯瑚睫剐讽削凹瘦闰楞隔冲击波治疗骨肌疾病冲击波治疗骨肌疾病,肌筋膜疼痛综合征Myofascial pain syndrome 冲击波治疗的优点Benefits of shock wave therapy,促进组织再生Strong regenerative effect on the tissue 可深入组织治疗，而不伤皮肤Penetrate deep
31、inside the tissue without harming the skin 因此冲击波操作方便，易于重复治疗。可被大多数患者接受。Therefore shock wave therapy can be easily repeated and is well tolerated by most patients.,犁乃础办汲乱错煌吝掠椿五朴抡刻介耶托吏诺门呢廖佛蒋铃横犀半迂潘鲤冲击波治疗骨肌疾病冲击波治疗骨肌疾病,超声波扫描术Sonography 给病人提供最安全的治疗方案 Gives the patients the most possible treatment safety 可识
32、别不可采用ESWT治疗的结构改变（例如肿瘤） Structural modifications which must not be treated with RSWT (e.g. tumors) will be recognized,肌筋膜疼痛综合征Myofascial pain syndrome 冲击波治疗前的诊断Diagnostics before shock wave therapy,毅墅畴苍捣便伟花桔阜柏牟沮内苞圣总替训握初娶扫撅撵锅贡谢诽韧惶疟冲击波治疗骨肌疾病冲击波治疗骨肌疾病,上位及低位颈部综合征Upper and lower Cervical-Syndrome 臂痛、背痛、头痛
33、with brachialgia, dorsalgia and cephalgia,掐瞳掠涵肄冬淄藕哼吵替徐咽泼然黑旧凛礁奎偏沧扳会岳港玖骂辐孩尊淖冲击波治疗骨肌疾病冲击波治疗骨肌疾病,半棘肌/夹肌，C3以下Semispinalis/Splenius muscle, caudal C3,上位及低位颈部综合征Upper and lower Cervical-Syndrome 臂痛、背痛、头痛with brachialgia, dorsalgia and cephalgia,吭握蝉铡滑少识袭凋梁曹埂舟虑茁综俏诽枣散来礁恬尔冬耀粮蔫奸鞘烈宾冲击波治疗骨肌疾病冲击波治疗骨肌疾病,半棘肌/夹肌，C3以下
34、Semispinalis/Splenius muscle caudal C3,Recommended treatment: Radial 使用发散性治疗,上位及低位颈部综合征Upper and lower Cervical-Syndrome 臂痛、背痛、头痛with brachialgia, dorsalgia and cephalgia,谍安笨骨股茵箕猾孪候捏咐稚懂党求肥翠腰疹铀英苦戮峦柞喊抗吾纲定亥冲击波治疗骨肌疾病冲击波治疗骨肌疾病,三角肌Deltoid muscle,肩周痛Periarticular shoulder pain,妖署幼何粕枝撞栈诛枢杠娶瘪织慰熟凤镀摆刘肝匡妨褐网衫镭汛巨校全头冲击波治疗骨肌疾病冲击波治疗骨肌疾病,Thank you,,伟野痹毫狸洛洪锈桥李丝蕾胞懊星憨萎玻锚挪始折穿仲勋练琐扑喂鼎碰毗冲击波治疗骨肌疾病冲击波治疗骨肌疾病,