体外冲击波联合关节腔及痛点阻滞对重度肩周炎松解术后的应用效果  

Application of extracorporeal shock wave combined with joint cavity and pain point block in the treatment of severe shoulder periarthritis

作　　者：蔡真真 林孙枝 黄志雄 Cai Zhenzhen;Lin Sunzhi;Huang Zhixiong(Department of Pain,Mindong Hospital of Ningde City,Fu'an,Fujian,355000China)

机构地区：[1]福建医科大学附属闽东医院疼痛科

出　　处：《当代医学》2019年第24期81-84,共4页Contemporary Medicine

基　　金：宁德市科技计划项目(20130159)

摘　　要：目的探讨体外冲击波联合关节腔及痛点阻滞在重度肩周炎松解术后的应用效果。方法收集本科室2013年7月至2017年8月120例符合重度肩周炎的患者,采用随机数字法分为3组:冲击波组、阻滞组及联合组,每组各40例。3组均采用复合麻醉下行手法松解,冲击波组予配合冲击波治疗,阻滞组予配合痛点+关节腔阻滞治疗,联合组予体外冲击波联合关节腔及痛点阻滞。连续治疗2周,观察治疗前、治疗1次后、治疗结束时、治疗后3个月VAS评分、肩关节活动度总评分,并评价其治疗3个月后的治疗疗效。结果在总体疗效上:联合组与阻滞组及冲击波组疗效比较,差异有统计学意义(P<0.05)。阻滞组及冲击波组疗效比较差异无统计学意义。3组在治疗1次后,治疗结束时,治疗后3个月其肩关节活动度总评分较同组治疗前均有明显改善(P<0.05)。在治疗3次后、治疗结束时、治疗后1个月同一时间段的比较,在活动度总评分的比较上联合组与阻滞组及冲击波组比较差异均有统计学意义(P<0.05)。VAS评分:联合组与阻滞组及冲击波组比较差异均有统计学意义(P<0.05)。结论与单纯的冲击波或阻滞比较,冲击波联合关节腔内及痛点阻滞对复合麻醉下手法松解后重度肩周炎患者的疼痛及改善其关节活动度疗效更佳。Objective To investigate the effect of extracorporeal shock wave combined with joint cavity and pain point block in the treatment of severe periarthritis of shoulder.Methods From July 2013 to August 2017,120 patients with severe periarthritis of shoulder were randomly divided into three groups:shock wave group,block group and combined group,with 40 cases in each group.The three groups were treated with combined anesthesia and manual release,and the shock wave group was treated with shock wave therapy.The block group was treated with pain spot and joint cavity block.The combined group was treated with extracorporeal shock wave combined with joint cavity and pain point block.Continuous treatment for 2 weeks.The VAS score and the total score of shoulder joint activity were observed before treatment,after one treatment,at the end of treatment and three months after treatment,and the therapeutic effect was evaluated after three months of treatment.Results Overall efficacy:comparison of efficacy between the combined group and block group and shock wave group:statistically significant(P<0.05).The difference of efficacy of block group and shock wave group was no statistically significant.After treatment for 1 time,3 groups showed significant improvement in the total activity score of the shoulder joint in 3 months after treatment(P<0.05).At the end of the treatment,treatment after 3 times,1 month after treatment at the same time,the comparison of the total score part formed in mobility compared with block and shock wave group difference was statistically significant(P<0.05),VAS score:joint group compared with block and shock wave group difference was statistically significant(P<0.05).Conclusion Compared with pure shock wave or block,the shock wave joint articular cavity and pain points block compound anesthesia technique after the release of severe patients with periarthritis of shoulder pain and improve the joint activity of curative effect is better.

关 键 词：体外冲击波 肩关节腔阻滞 痛点阻滞 复合麻醉 手法松解 重度肩周围炎 VAS评分 肩关节活动度 

分 类 号：R68[医药卫生—骨科学]