体外放散式冲击波治疗臂外侧上皮神经卡压综合征的疗效分析  

Effectiveness of Extracorporeal Shockwave Therapy in Treating Superior Lateral Brachial Cutaneous Nerve Compression Syndrome

作　　者：潘昭勋[1] 闵小军 孙超[1] 杜德凯 PAN Zhaoxun;MIN Xiaojun;SUN Chao;DU Dekai(Department of Joint Surgery,the 89th Hospital of PLA,Weifang,Shangdong 261021,China)

机构地区：[1]中国人民解放军第八十九医院关节外科,山东潍坊261021

出　　处：《中国医学科学院学报》2018年第3期344-348,共5页Acta Academiae Medicinae Sinicae

基　　金：全军后勤科研计划项目(CJN13J002)~~

摘　　要：目的评估体外放散式冲击波治疗(r ESWT)臂外侧上皮神经卡压综合征的临床疗效。方法以2013年3月至2015年10月在中国人民解放军第八十九医院关节外二科治疗的40例臂外侧上皮神经卡压综合征患者为研究对象,采用随机数字表法随机分为两组(每组20例),分别给予r ESWT(r ESWT组)和使用封闭药物进行局部痛点注射(封闭组)治疗1疗程,对两组患者治疗前、治疗后1个月和1年后的视觉模拟评分(VAS)及Constant-Murley肩关节功能评分(CMS)进行评估,比较两组患者的临床疗效。结果治疗前,r ESWT组和封闭组患者的平均CMS评分分别为(66.7±0.9)和(65.7±1.1)分,差异无统计学意义(t=0.67,P=0.510);治疗后1个月,两组的平均CMS评分分别为(86.9±1.0)和(86.4±1.1)分,差异也无统计学意义(t=0.35,P=0.730);治疗后1年,r ESWT组的平均CMS评分为(89.7±0.7)分,明显高于封闭组的(85.3±0.8)分(t=3.56,P=0.002)。r ESWT组的末次随访改善率为95%,封闭组则为75%。治疗前,r ESWT组和封闭组患者的中位VAS评分分别为5.00(5.00,6.00)和5.00(4.00,5.75)分,差异无统计学意义(u=1.13,P=0.29);治疗后1个月,两组的中位VAS评分分别为2.00(1.00,2.75)和2.00(1.00,2.00)分,差异也无统计学意义(u=0.04,P=0.85);治疗后1年,r ESWT组的中位VAS评分为1.00(0.00,1.00)分,明显低于封闭组的2.00(1.00,2.00)分(u=5.09,P=0.02)。结论与针刺封闭治疗相比,r ESWT治疗臂外侧上皮神经卡压综合征的疼痛改善率较高,术后1年肩关节功能恢复更好。Objective To evaluate the effectiveness of radial extracorporeal shockwave therapy（ r ESWT） for the treatment of superior lateral brachial cutaneous nerve（ SLBCN） compression syndrome. Methods A total of 40 patients with SLBCN compression syndrome who were treated in our department from March 2013 to October 2015 were equally randomized into two groups according to random number table： r ESWT group（treated with r ESWT for 1 cycle） and control group（treated with local hormone injection for 1 cycle）. Visual analogue scale（ VAS） and Constant-Murley scale（ CMS） were applied to evaluate the shoulder joint function before treatment and 1 month and 1 year after treatment. Results The average CMS scores were（66. 7 ± 0. 9）and（65. 7 ± 1. 1） scores in r ESWT group and control group,respectively,before treatment（ t = 0. 67,P =0. 510） and were（86. 9 ± 1. 0） and（86. 4 ± 1. 1） scores one month after treatment（ t = 0. 35,P = 0. 730）;it increased to（89. 7 ± 0. 7） scores in r ESWT group one year later,which was significantly higher than that in control group [（85. 3 ± 0. 8） scores]（ t = 3. 56,P = 0. 002）. The improvement rate was 95% in r ESWT group and only 75% in control group. Before treatment,the median VAS score in r ESWT group and control group were 5. 00（5. 00,6. 00） and 5. 00（ 4. 00,5. 75） scores（ u = 1. 13, P = 0. 29）; one month after treatment,the median VAS score in these two groups were 2（1. 00,2. 75） and 2. 00（1. 00,2. 00） scores（u = 0. 04,P = 0. 85）; one year later,it was 1. 00（0. 00,1. 00） scores in r ESWT group,significantly lower than that in [2. 00（1. 00,2. 00） scores]control group（ u = 5. 09,P = 0. 02）. Conclusion Compared with local hormone injection,r ESWT can remarkably alleviate pain and restore shoulder joint function in patients with SLBCN compression syndrome after one year of treatment.

关 键 词：体外放散式冲击波 封闭注射 臂外侧上皮神经 视觉模拟评分 Constant-Murley肩关节功能评分 

分 类 号：R686.1[医药卫生—骨科学]