关节镜联合罗哌卡因、玻璃酸钠治疗冻结肩临床疗效分析  

Analysis of Clinical Curative Effect of Arthroscope Combined with Ropivacaine and Sodium Hyaluronate in Treatment of Frozen Shoulder

作　　者：徐雅强[1] 焦绪彬[1] 刘振刚[1] 郝宗文[1] 刘雪艳[1] XU Ya-qiang JIAO Xu-bin LIU Zhen-gang HAO Zong-wen LIU Xue-yan(Department of Joint Surgery, Changyi People＇s Hospital of Shandong Province,Changyi,Shandong Province, 261300 China)

机构地区：[1]山东省昌邑市人民医院关节外科,山东昌邑261300

出　　处：《系统医学》2017年第3期64-66,共3页Systems Medicine

摘　　要：目的为探讨罗哌卡因、玻璃酸钠药物对关节镜下松解冻结肩术后关节功能的主观、客观恢复程度的影响,寻找一种简单有效的治疗冻结肩的临床方法。方法该试验以临床随机对照试验的基本原则为基准,按一定的纳入排除标准,随机抽取2015年1月—2016年1月昌邑市人民医院关节外科的40例需行关节镜下松解的冻结肩患者,随机分为2组,术后包扎前给予罗哌卡因和玻璃酸钠药物(A组)腔内注射,术后无药物注射(B组),在康复医师双盲的原则下,观察受试验者在既定时间点的主观、客观肩关节功能情况评分,采用评分标准SF-36和Constant评分系统。结果对结果分析后,A、B两组术后较术前功能评分相比差异有统计学意义(P<0.05)。A组在术后前2个月内,SF-36评分分别为(84±8)分、(88±7)分、(106±6)分、(120±6)分、(130±4)分、(132±5)分,Constant评分分别为(67±5)分、(72±5)分、(75±9)分、(80±5)分、(83±3)分、(84±3)分,分别优于B组同时间评分,组间差异有统计学意义(P<0.05),但在术后3月以后,A、B两组差异无统计学意义(P>0.05)。结论镇痛方法和时机的选择是肩关节镜下松解冻结肩的术后镇痛效果的关键,肩关节术后的疼痛减轻往往与肩关节早期功能锻炼和康复呈正相关。两者联合用药对关节镜下松解冻结肩术后功能恢复效果的主观、客观评估,目前尚未见报道。通过结果分析可看出,关节镜下松解冻结肩,术后联合应用罗哌卡因、玻璃酸钠,短期内肩关节功能评分、恢复速度和比率最优,该方案是治疗冻结肩的临床有效治疗方法。Objective To discuss the effect of arthroscope and sodium hyaluronate on the objective and subjective recovery degree of joint function after the frozen shoulder treated with arthroscopic lysis and search for an easy and effective clinical treatment method of frozen shoulder. Methods 40 cases of patients with frozen shoulder treated with arthroscopic lysis in the department of joint surgery in our hospital from January 2015 to January 2016 were randomly selected and randomly divided into two groups, the group A were given the intracavitary administration of arthroscope combined with sodium hyaluronate after operation, while the group B were not given the drug injection after operation, and the subjective and objective shoulder joint function scores were scored by the SF-36 and Constant marking system according to the double blind principle. Results The difference in the function score of the two groups before and after operation was obvious with statistical significance（P〈0.05）, and in the 2 months after operation, the SF-36 score and Constant score were respectively （84±8）points,（88±-7）points,（106±6）points,（120±6）points,（130±4）points,（132±5）points and （67±5）points,（72±5）points,（75±9）points,（80±5）points,（83±3）points,（84±3）points, which were better than those in the group B, and the differences had statistical significance （P〈0.05）, and the difference between the group A and the group B in 3 months after operation had no statistical significance （P〉0.05）. Conclusion The selection of analgesia method and time is the key to the analgesia effect after the frozen shoulder treated with arthroscopic lysis, and the relief of the postoperative pains after shoulder joint is usually positively correlated with the early function exercise and recovery of shoulder joint, and the subjective and there is no report about the objective evaluation of the combined medication on the recovery effect of function after the frozen shoulder treated with arthrosc

关 键 词：肩关节镜 冻结肩 玻璃酸钠 罗哌卡因 

分 类 号：R684[医药卫生—骨科学]