右美托咪定复合罗哌卡因甲钴胺混合液治疗肩周炎疗效观察  

The therapeutic effect of local injection of a mixture of dexmedetomidine with ropivacaine and mecobalamin in the treatment of periathritis of shoulder

作　　者：任丹凤[1] 曹敏芳[1] 王冬燕 王芳[1] REN Dan-feng;CAO Min-fang;WANG Dong-yan;WANG fang(Department of Anesthesiology,Xiaoshan First People's Hospital,Xiaoshan,Zhejiang 300201,China)

机构地区：[1]杭州市萧山区第一人民医院麻醉科,浙江杭州311200

出　　处：《中国预防医学杂志》2019年第4期308-311,共4页Chinese Preventive Medicine

基　　金：浙江省医学会临床科研资金项目(2015ZYC-A43)

摘　　要：目的观察B超引导下局部注射右美托咪定+罗哌卡因治疗肩周炎的治疗效果。方法选取2015年11月至2017年3月,杭州市萧山区第一人民医院收治的100例肩周炎患者,随机分为治疗组和对照组,每组50例,均采用在B超引导下混合液分别注射于肩岬上神经和喙突、岗下肌、小圆肌。治疗组混合液为0.5 mg/L右美托咪定+0.1%罗哌卡因+甲钴胺1 mg;对照组混合液为0.1%罗哌卡因+甲钴胺1 mg。观察治疗后效果从注入药物起开始计时,注射后15 min、24 h、 1周、1月的效果。比较两组的疗效、NRS疼痛评分、运动阻滞评分、肩关节活动度评分、血流动力学、复发率和再治疗率、不良反应。结果治疗组与对照组相比,治疗组总有效率较高(χ~2=6.06,P<0.05),治疗组NRS疼痛评分低于对照组(P<0.05),关节活动度评分高于治疗组(P<0.05)。治疗组运动阻滞情况优于对照组(Z=12.34,P<0.01)。治疗组复发3例,再治疗3例,对照组复发10例,再治疗11例,对照组复发率和再治疗率均高于治疗组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论在疼痛改善,活动度改善等方面右美托咪定组疗效优于对照组,且无明显血流动力学影响。Objective To observe the effect of ultrasound-guided local injection of dexmedetomidine mixed with ropivacaine and mecobalamin in the treatment of scapulohumeral periarthritis. Methods A total of 100 patients with scapulohumeral periarthritis treated in our hospital from November 2015 to March 2017 were enrolled and randomly divided into study group(50 cases) and control group(50 cases).Patients in study group received local injection of dexmedetomidine(0.5 mg/L) mixed with ropivacaine(0.1%) and Mecobalamin(1 mg), while those in control group only received a mixture of ropivacaine(0.1%) and mecobalamin(1 mg) injection.The mixtures were injected into the scapular nerve and coracoid, infraspinatus muscle, small Ling muscle under ultrasonic guidance.The effects were observed and evaluated at 15 min, 24 h, 1 week and 1 month after the injection.The clinical efficacy, NRS pain score, motor block score, shoulder mobility score, hemodynamics, recurrence rate, retreatment rate and adverse reactions were compared between the two group. Results After the treatment, the overall effective rate was significantly higher among patients in study group than that of controls(χ^2=6.06, P<0.05), with much lower NRS pain score(P<0.05), higher joint activity score(P<0.05) and less motor block(Z=12.34,P<0.01).The recurrence rate and the retreatment rate in the control group were both higher than those in the study group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusions The local injection of dexmedetomidine mixed with ropivacaine and mecobalamin can help to relieve the shoulder pain,improve the mobility of the shoulder with no obvious hemodynamic effect.

关 键 词：B超引导 右美托咪定 罗哌卡因 联合治疗 肩周炎 疼痛 活动度 

分 类 号：R969.4[医药卫生—药理学]