扇形松解扩张治疗老年急性肩峰下滑囊炎多中心临床观察  

Efficacy of Fan-shaped Release Hydraulic Dilatation in Treating Acute Subacromial Bursitis in the Elderly:Multicenter Clinical Trail

作　　者：孙润军 何戟锋 陈永坚 王晨[1] 侯炜[1] 黄小霞 陆晓玲 沈贤东 张帅 张蓉 司徒海燕 徐洁[1] 张霆[1] SUN Runjun;HE Jifeng;CHEN Yongjian;WANG Chen;HOU Wei;HUANG Xiaoxia;LU Xiaoling;SHEN Xiandong;ZHANG Shuai;ZHANG Rong;SITU Haiyan;XUJie;ZHANG Ting(Department of Orthopaedics,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Ningbo Branch,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Ningbo 315200,Zhejiang China;Pudong New Area Hospital of Traditional Chinese Medicine,Shanghai 200120,China;Jinqiao Community Health Service Centre,Shanghai 201206,China;Jiulonghu Town Health Center,Ningbo 315205,Zhejiang China)

机构地区：[1]上海中医药大学附属龙华医院骨伤科,上海200032 [2]上海中医药大学附属龙华医院宁波分院(宁波市镇海中医院) [3]上海浦东新区中医医院 [4]上海浦东新区金桥社区卫生服务中心 [5]浙江宁波市镇海区九龙湖镇卫生院

出　　处：《中国中医骨伤科杂志》2020年第6期37-41,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：上海市卫健委中医药项目(2016LP042);浦东新区联合攻关项目(PW2017D-5);宁波市卫健委课题(2017A42)。

摘　　要：目的:临床观察经皮穿刺扇形松解结合液压扩张治疗老年急性期肩峰下滑囊炎疗效及安全性。方法:2017年1月至2019年6月期间,对住院及门诊符合诊断标准的急性肩峰下滑囊炎老年患者100例,简单随机分为治疗组与对照组,对照组给予喙突旁穿刺,单次注射1%利多卡因10 mL、曲安奈德1 mL,直接拔针;治疗组给予肩峰下前方穿刺,以穿刺针行肩峰下扇形挑拨松解,注射前药后,连接0.9%NS加压至180 mmHg(23.94 kPa),滴注维持10 min后拔针。两组均单次治疗后随访3个月(84 d),记录并统计分析患者治疗前、治疗后VAS、肩关节疼痛及功能障碍指数和肩关节功能评分。同时观察并记录患者的不良反应,评价治疗的安全性。结果:治疗组患者治疗后疼痛较对照组有明显改善(P<0.01),且差异维持4周以上。肩关节疼痛及功能障碍指数两组治疗前后差异有统计学意义(P<0.05)。结论:经皮穿刺扇形松解结合液压扩张技术治疗老年急性期肩峰下滑囊炎在快速控制疼痛方面有着极为良好的效果,值得深入探讨。Objective:To observe the efficacy of fan-shaped release hydraulic dilatation in treating acute subacromial bursitis in the elderly in multicenter clinical trail.Methods:From January 2017 to June 2019,100 cases of acute subacromial bursitis in the elderly were randomly divided into treatment and control group.The control group was treated with paracaphyseal puncture and 1%lidocaine 10 mL and triamcinolone acetonide 1 mL.The treatment group was treated with anterior subacromial puncture and subacromial segmental provocation 0.9%NS was added to the premedication and the post-medication for 10 min.Both groups were followed up for 84 d after the one time treatment.VAS,SPADI and CM scores before and after treatment were recorded and analyzed.At the same time,adverse reactions were observed and recorded to evaluate the safety of treatment.Results:The pain in the treatment group was significantly improved compared with the control group(P<0.01),and the difference was maintained for more than 4 weeks.There were significant differences between the two groups before and after treatment(P<0.05).Conclusion:Percutaneous fan-shaped release combined with hydraulic dilatation technology has a good effect in treating acute subacromial bursitis in the elderly,which is worthy of in-depth study.

关 键 词：液压扩张 针刀治疗 肩峰下滑囊炎 肩关节周围炎 

分 类 号：R686.7[医药卫生—骨科学]