关节镜微创术与保守药物治疗早期原发性冻结肩的临床比较  

Clinical Comparison of Arthroscopic Minimally Invasive Surgery and Conservative Medication for Early Primary Frozen Shoulder

作　　者：叶桂秀 叶俊材[2] 洪忠 刘立林 YE Guixiu;YE Juncai;HONG Zhong;LIU Lilin(Ganzhou City Nankang District First People’s Hospital,Ganzhou 341400,China;不详)

机构地区：[1]江西省赣州市南康区第一人民医院,江西赣州341400 [2]浙江中医药大学附属第三医院

出　　处：《中国医学创新》2019年第35期61-66,共6页Medical Innovation of China

摘　　要：目的:探究关节镜微创术与保守药物治疗早期原发性冻结肩(PFS)的临床效果。方法:选取2015年3月-2018年3月收治的106例PFS早期患者为研究对象,根据Nevaiser分期,Ⅰ期54例,Ⅱ期52例。根据住院号单双数将PFSⅠ期患者分为关节镜微创术组(A组,n=27)和药物治疗组(B组,n=27),将Ⅱ期患者分为关节镜微创术组(C组,n=26)和药物治疗组(D组,n=26)。分别观察Ⅰ、Ⅱ期患者两组治疗前后关节活动度(ROM)、关节疼痛程度[视觉模拟评分法(VAS)]、肩关节功能(Constant-Murley评分)等指标变化情况。结果:Ⅰ、Ⅱ期患者治疗后4周、12周、1年VAS评分均较治疗前降低,ROM、Constant-Murley评分均较治疗前升高,差异均有统计学意义(P<0.05);治疗后4周,关节镜微创术组VAS评分高于药物治疗组,ROM、Constant-Murley评分均低于药物组,差异均有统计学意义(P<0.05),治疗后12周、1年,关节镜微创术组VAS评分均低于药物治疗组,ROM、Constant-Murley评分均高于药物治疗组,差异均有统计学意义(P<0.05)。结论:早期PFS(Ⅰ、Ⅱ期)患者采取关节镜微创术与保守药物治疗均能取得一定疗效,药物治疗早期疗效好,而微创手术远期疗效更佳,可有效改善肩关节活动度和功能,缓解疼痛,促进疾病转归。Objective:To explore the clinical efficacy of arthroscopic minimally invasive surgery and conservative medication in the treatment of early primary frozen shoulder(PFS).Method:A total of 106 patients with early PFS from March 2015 to March 2018 were selected for the study.According to the Nevaiser stage,there were 54 cases in stageⅠand 52 cases in stageⅡ.According to the odd and even hospital number,patients with PFS in stageⅠwere divided into arthroscopic minimally invasive surgery group(group A,n=27)and medication treatment group(group B,n=27),and the patients in stageⅡwere divided into arthroscopic minimally invasive surgery group(group C,n=26)and medication treatment group(group D,n=26).The changes of joint range of motion(ROM),joint pain degree[visual analogue scale(VAS)]and shoulder joint function(Constant-Murley score)before and after treatment were observed in patients in stageⅠand stageⅡrespectively.Result:The VAS scores of patients in stageⅠand stageⅡat 4 weeks,12 weeks and 1 year after treatment were lower than those of before treatment,and the ROM and Constant-Murley scores were higher than those of before treatment(P<0.05).4 weeks after treatment,the VAS score in arthroscopic minimally invasive surgery group was higher than that in medication treatment group,while the ROM and Constant-Murley scores were lower than those in medication treatment group(P<0.05).12 weeks and 1 year after treatment,the VAS scores in arthroscopic minimally invasive group were lower than those in medication treatment group,while the ROM and Constant-Murley scores were higher than those in medication treatment group(P<0.05).Conclusion:Arthroscopic minimally invasive surgery and conservative medication therapy for patients with early PFS(stageⅠand stageⅡ)both can achieve certain efficacy,and the medication therapy has better early efficacy,but minimally invasive surgery has better long-term efficacy,and can effectively improve the ROM and function of shoulder joint,relieve pain and promote disease outcomes.

关 键 词：关节镜微创术 早期原发性冻结肩 关节活动度 视觉模拟评分 

分 类 号：R687.4[医药卫生—骨科学]