关节镜下关节囊松解与臂丛麻醉下手法松解治疗冻结肩疗效对比分析  

Comparative effects of arthroscopic lysis and manipulation under anesthesia for frozen shoulder

作　　者：孙敬华[1] 阮文礼[1] 刘大凯[1] 

机构地区：[1]大连市第二人民医院骨科,辽宁大连116100

出　　处：《临床军医杂志》2017年第12期1240-1243,共4页Clinical Journal of Medical Officers

摘　　要：目的比较关节镜下松解与臂丛麻醉下手法松解治疗冻结肩的术后疗效。方法选取自2013年1月至2015年12月大连市第二人民医院收治的冻结肩患者50例为研究对象,采用机械抽样法将患者随机分为手法松解组(n=25)和关节镜组(n=25)。手法松解组采用臂丛麻醉下行手法松解,关节镜组采用关节镜下松解关节囊。观察并比较两组患者的住院及随访时间、肩关节活动度、肩关节Constant功能评分、疼痛视觉模拟评分(VAS)、治疗费用及并发症发生情况。结果两组患者的住院及随访时间比较,差异均无统计学意义(P>0.05);两组患者术前肩关节被动外展、前屈、后伸、外旋活动度比较差异无统计学意义(P>0.05);关节镜组患者术后肩关节被动外展、前屈、后伸、外旋活动度分别为(118.2°±11.2°)、(125.8°±8.4°)、(36.6°±3.7°)、(61.4°±6.0°),均优于手法松解组的(86.4°±6.0°)、(91.4°±8.5°)、(29.3°±5.8°)、(44.7°±7.0°),两组比较,差异有统计学意义(P<0.05)。关节镜组患者术后肩关节功能评分为(70.2±5.5)分,优于手法松解组的(54.0±6.3)分,两组比较,差异有统计学意义(P<0.05)。两组患者术后VAS评分比较,差异无统计学意义(P>0.05)。关节镜组治疗费用明显高于手法松解组,两组比较,差异有统计学意义(P<0.05)。两组患者均未出现术中并发症及术后肩关节不稳定,无术后神经损伤。结论肩关节镜下松解术治疗冻结肩在肩关节活动度和功能上的效果优于手法松解术,临床效果满意。Objective To compare and analyze the effects of arthroscopic lysis and manipulation under anesthesia for frozen shoulder.Methods A retrospective study was performed on 50 cases of patients with frozen shoulder who were admitted from January 2013 to December 2015. Patients were randomly divided into the manipulation group（ M group,n = 25） and arthroscopic group（ A group,n =25）. Patients in M group were given manipulation under anesthesia,the others in A group were given arthroscopic lysis. To observe and compare the two groups of patients in hospitalization and follow-up time,shoulder joint activity,shoulder joint Constant function score,pain visual analogue score（ VAS）,treatment cost and complications. Results There was no statistically significant difference in hospitalization and follow-up time between the two groups（ P〉0. 05）. There were no significant differences in patients with shoulder joint after passive outreach,anteflection,backward extension and extorsion mobility between the two groups（ P〈0. 05）. In the A group,the passive outreach,anteflection,backward extension and extorsion mobility were better than those in the M group：（ 118. 2° ± 11. 2°） versus（ 86. 4° ± 6. 0°）,（ 125. 8° ± 8. 4°） versus（ 91. 4° ± 8. 5°）,（ 36. 6° ± 3. 7°） versus（ 29. 3° ± 5. 8°） and（ 61. 4° ± 6. 0°） versus（ 44. 7° ± 7. 0°）,respectively,（ P〈0. 05）. The score of shoulder joint function after surgery was（ 70. 2 ± 5. 5） points in A group,which was better than（ 54. 0 ± 6. 3） points in M group（ P〈0. 05）. There was no significant difference in VAS score between the two groups（ P〉0. 05）. The treatment cost in the A group was significantly higher than that in the M group（ P〈0. 05）. None of the patients had intraoperative complications and postoperative shoulder instability without postoperative nerve injury. Conclusion The efficacy of frozen shoulder with arthroscopic lysis treatment is better than manipulation under anesthes

关 键 词：冻结肩 肩关节镜 手法松解术 

分 类 号：R473.6[医药卫生—护理学]