肩胛上神经阻滞与肩峰下滑囊注射对于肩袖撕裂患者的短期疗效分析  

Short-term Efficacy of Suprascapular Nerve Block and Subacromial Bursa Injection in Patients with Rotator Cuff Tear

作　　者：解波 黎已莲 张秀平[1] 徐静[1] 王福梅 Xie Bo;Li Yilian;Zhang Xiuping;Xu Jing;Wang Fumei(Department of Anesthesiology,Zigong Third People's Hospital,Zigong 643020,China;Operating Room,Zigong Third People's Hospital,Zigong 643020,China)

机构地区：[1]四川省自贡市第三人民医院麻醉科,自贡643020 [2]四川省自贡市第三人民医院手术室,自贡643020

出　　处：《成都医学院学报》2020年第1期109-111,114,共4页Journal of Chengdu Medical College

摘　　要：目的探讨肩胛上神经阻滞与肩峰下滑囊注射两种不同方式的保守治疗对于肩袖撕裂患者预后影响。方法回顾性分析于2016年6月至2019年3月在四川省自贡市第三人民医院麻醉科检查、诊断为肩袖撕裂患者并行肩胛上神经阻滞与肩峰下滑囊注射治疗的患者47例;按其治疗方式分为肩胛上神经阻滞组25例(试验组)与肩峰下滑囊注射(对照组)22例;试验组予以超声引导下1%罗哌卡因9mL和倍他米松1mL进行肩胛上神经阻滞,对照组予以1%罗哌卡因9mL和倍他米松1mL进行肩峰下滑囊注射治疗;观察两种不同局部麻醉方式的治疗效果,治疗前,治疗后2、6和12周Constant-Marley肩关节功能评分(CM评分)和评估疼痛的视觉模拟评分(VAS评分)变化。结果在治疗后2、6、12周两组VAS评分相比较,差异无统计学意义(P>0.05)。重复测量方差分析:分组对于VAS评分无影响(P>0.05),时间因素对于患者VAS有影响(P<0.05),时间因素与分组因素之间无交互作用(P>0.05);在治疗后6、12周两组CM评分相比较,差异有统计学意义(P<0.05);重复测量方差分析:分组对于CM评分有影响(P<0.05),时间因素对于患者CM无影响(P>0.05),时间因素与分组因素之间有交互作用(P<0.05)。结论肩关节撕裂患者两种不同保守治疗方式在肩袖撕裂患者疗效上存在一定差异,CM评分在肩胛上神经阻滞组高于肩峰下滑囊注射组,肩胛上神经阻滞有利于肩关节功能恢复。Objective To investigate the prognostic effect of the two conservative treatments including suprascapular nerve block and subacromial bursa injection in the treatment of patients with rotator cuff tear.Methods The complete data of 47 patients diagnosed with rotator cuff tear and treated with suprascapular nerve block or subacromial bursa injection in Zigong Third People’s Hospital from June of 2016 to March of 2019 were analyzed retrospectively.The 25 patients treated with suprascapular nerve block were divided into the experiment group,and the other 22 patients treated with subacromial bursa injection were divided into the control group.The experiment group was given the suprascapular nerve block with 9 ml of 1%ropivacaine and 1 ml of betamethasone under the guidance of ultrasound,while the control group was given the subacromial bursa injection with 9 mL of 1%ropivacaine and 1 mL of betamethasone.The changes of the Constant-Murley shoulder scores and Visual Analogue Scale(VAS)scores before treatment and at 2,6 and 12 weeks after treatment were observed in the two groups.Results There were no significant differences in the VAS scores at 2,6 and 12 weeks after treatment between the two groups(P>0.05).According to the results of the repeated measurement variance analysis,grouping had no effect on the VAS score(P>0.05),time had effect on the VAS score(P<0.05),and there was no interaction effect between time and grouping(P>0.05).Grouping had effect on the Constant-Murley shoulder score,time had no effect on the Constant-Murley shoulder score,and there was interaction effect between time and grouping(P<0.05).Conclusion There are some differences in the curative effect of the two different conservative treatments in patients with rotator cuff tear.The Constant-Murley shoulder score is higher in the treatment with suprascapular nerve block than in the treatment with subacromial bursa injection,which suggests that suprascapular nerve block is more beneficial to the recovery of shoulder joint function.

关 键 词：肩袖撕裂 肩胛上神经 滑囊 神经阻滞 

分 类 号：R683.41[医药卫生—骨科学]