超声引导针刀选择性松解治疗冻结肩的初步疗效  

Primary clinical outcomes of ultrasound guided selective release with needle knifes for frozen shoulder

作　　者：刘小晨 张鹏[1] 张小璐[1] LIU Xiao-chen;ZHANG Peng;ZHANG Xiao-lu(Qingdao Municipal Hospital,Qingdao 266011,China)

机构地区：[1]青岛市市立医院,山东青岛266011

出　　处：《中国矫形外科杂志》2020年第24期2254-2257,共4页Orthopedic Journal of China

摘　　要：[目的]评价超声引导下针刀选择性松解治疗冻结肩的临床疗效。[方法] 2018年3月~2019年6月,原发性冻结肩患者75例随机分为两组,超声组37例采用超声引导下肩关节前后入路选择性松解治疗,常规组38例采用常规肩关节针刀松解治疗。比较两组患者临床与超声影像资料。[结果]随着时间的延长,两组患者的VAS评分显著减少(P<0.05),而SST评分显著增加(P<0.05)。超声组术后12周VAS评分,以及术后3周和12周SST评分显著优于常规组(P<0.05)。与术前相比,两组间患者主动前屈、外旋、内旋、外展ROM均显著增加(P<0.05);术后12周超声组主动前屈、外旋、内旋ROM显著优于常规组(P<0.05)。超声检查方面,与术前相比,术后12周两组患者CHL和PCT厚度显著减少(P<0.05),而GHD显著增加(P<0.05)。术后12周超声组的CHL和PCT厚度显著小于常规组(P<0.05),而超声组GHD显著大于常规组(P<0.05)。[结论]超声引导下针刀选择性松解治疗冻结肩操作安全、早期疗效明显优于传统针刀松解术。[Objective] To evaluate the clinical efficacy of ultrasound guided selective release with needle knifes for frozen shoulder. [Methods] From March 2018 to June 2019, 75 patients with primary frozen shoulder were randomly divided into two groups. Of them, 37 patients in the ultrasound group had anterior and posterior selective release with needle knifes under the guidance of ultrasound, while the remaining 38 patients in the routine group received conventional needle-knife therapy. The clinical and sonographic documents were compared between the two groups. [Results] The VAS scores significantly decreased,whereas the SST score significantly increased over time in both groups(P<0.05). The ultrasound group proved significantly superior to the routine group in VAS score at 12 weeks, and SST score at 3 and 12 weeks after operation(P<0.05). In addition, the shoulder active range of motion(ROM), including anterior flexion, external rotation, internal rotation and abduction significantly enhanced in both groups at 12 weeks after operation compared with those before operation(P<0.05). The ultrasound group was significantly superior to the routine group regarding anterior flexion, external rotation and internal rotation at 12 weeks postoperatively(P<0.05). With regard to sonographic assessment, the thicknesses of coracohumeral ligament and posterior capsule significantly declined, whereas the glenohumeral distance significantly increased in both groups at 12 weeks postoperatively compared with those before operation(P<0.05), and the ultrasound group was significantly superior to the routine group in aforesaid parameters at 12 weeks after operation(P<0.05). [Conclusion] The ultrasound guided selective release with needle knifes for frozen shoulder is considerably superior to the conventional technique in security and early clinical outcomes.

关 键 词：冻结肩 超声检查 针刀治疗 松解 

分 类 号：R687[医药卫生—骨科学]