臂丛麻醉下手法松解治疗冻结肩的临床研究  

A clinical study of manipulation under brachial plexus anesthesia for the treatment of frozen shoulder

作　　者：刘继军[1] 郑国柱[2] 赵炬才[1] 

机构地区：[1]河南省人民医院骨科研究所,河南郑州450003 [2]中山医科大学孙逸仙纪念医院

出　　处：《中国骨伤》2000年第11期649-650,共2页China Journal of Orthopaedics and Traumatology

摘　　要：目的　探讨臂丛麻醉下手法松解治疗冻结肩的效果及机制。方法　对 90例 (92肩 )冻结肩进行臂丛麻醉下手法松解 ,2 8肩在松解前进行肩关节造影 ,5肩于关节功能完全恢复后 ,再次进行肩关节造影。结果　随访 8～ 43个月 ,手法松解 92肩 ,优 86肩 ,良 6肩 ,差 0肩。 3例出现麻醉并发症。造影显示 ,松解前关节腔容积明显变小 ,平均 7ml,关节囊粘连挛缩 ,以腋隐窝及肱二头肌长头腱鞘最严重。康复后关节造影显示 ,关节囊边缘光滑 ,未见造影剂外渗。结论　臂丛麻醉下手法松解治疗冻结肩疗效显著。麻醉后运用手法可充分松解关节囊内粘连 ,松解过程中撕裂的关节囊在患肩主动功能锻炼过程中 ,可获得重新修复。HT5”H]Objective [HT5”SS]To investigate the clinical results and mechanism of manipulation under brachial plexus anesthesia for the treatment of frozen shoulder.[HT5”H]Methods [HT5”SS]90 cases(92 joints) of frozen shoulders were treated by close manipulation under brachial plexus anesthesia.Arthrography was performed before manipulation in 28 shoulders.This examination were performed repeatedly in 5 cases after the shoulder joint function had recovered.[HT5”H]Results [HT5”SS]The duration of follow up ranged from 8 to 43 months.The excellent results were obtained in 86 shoulders,good in 6.The anesthesia complications occurred in 3 cases.The arthrography showed that before manipulation the volume of articular cavity was much smaller than usual size and joint capsule contracted especially serious in axillary fossa and tendon sheath of long head of biceps brachii muscle.After manipulation,the edges of joint capsule became smooth.[HT5”H]Conclusion [HT5”SS]Excellent and good results were obtained from this treatment.Adhesion of joint capsule could be relaxed after treatment and the torn joint capsules could be reconstructed during the course of active exercises. [WT5”HZ]

关 键 词：手法治疗 冻结肩 臂丛麻醉 疗效 

分 类 号：R684.05[医药卫生—骨科学] R614.4[医药卫生—外科学]