超声引导臂丛麻醉下手法松解加内热式骨骼肌附着点松解术用于冻结肩的疗效分析  

Analysis of the efficacy of ultrasound guided brachial plexus anesthesia manipulation release combined with internal heat needles skeletal muscle attachment point release for frozen shoulder

作　　者：李静[1] 黄莹[1] 周建斌[2] 朱彤[1] 林建[1] 陶高见[1] LI Jing;HUANG Ying;ZHOU Jianbin;ZHU Tong;LIN Jian;TAO Gaojian(Department of PainMedicine,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical College,Jiangsu Province,Nanjing210008,China;Department of Pain,Nanjing Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Nanjing University of Chinese Medicine,Jiangsu Province,Nanjing210014,China)

机构地区：[1]南京大学医学院附属鼓楼医院疼痛医学科,江苏南京210008 [2]南京中医药大学附属南京市中西医结合医院疼痛科,江苏南京210014

出　　处：《中国医药导报》2021年第31期115-118,127,共5页China Medical Herald

基　　金：江苏省自然科学基金资助项目(BK20180130)。

摘　　要：目的探讨超声引导臂丛麻醉下手法松解加内热式骨骼肌附着点松解术用于冻结肩的临床疗效。方法选取2019年1月至2020年6月南京大学医学院附属鼓楼医院疼痛医学科诊断为冻结肩的62例患者为研究对象。按随机数字表法分为A、B组,A组(30例)在超声引导的臂丛下接受手法松解,辅以口服非甾体类药物,并嘱患者行肩关节锻炼;B组(32例)在A组基础上加行内热式经皮骨骼肌附着点松解术。比较两组治疗前和治疗后7、30、90 d的视觉模拟评分法(VAS)评分及Constant-Murley肩关节功能评分;比较两组临床疗效,记录治疗过程中不良反应的发生情况。结果治疗后,两组各时间点VAS评分与治疗前比较,差异均有统计学意义(P<0.05);B组各时间点VAS评分低于A组,差异均有统计学意义(P<0.05)。治疗后,两组各时间点Constant-Murley肩关节功能评分与治疗前比较,差异均有统计学意义(P<0.05);B组各时间点Constant-Murley肩关节功能评分高于A组,差异均有统计学意义(P<0.05)。治疗后7、30、90 d,两组愈显率比较,差异有统计学意义(P<0.05)。两组均未见神经损伤,局麻药中毒及肩周肌肉、肌腱损伤等并发症。结论超声引导臂丛麻醉下手法松解加内热式骨骼肌附着点治疗冻结肩的效果可靠,具有安全性高、见效快、效果持久、不良反应少等优点。Objective To investigate the clinical effect of ultrasound guided brachial plexus anesthesia manipulation release combined with internal heat needles skeletal muscle attachment point release for frozen shoulder.Methods A total of 62 patients diagnosed with frozen shoulder from January 2019 to June 2020 in the Department of Pain Medicine,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical College were selected as the research subjects.They were divided into group A and group B,according to the random number table method.Group A(30 cases)received ultrasound guided brachial plexus anesthesia manipulation release supplemented by oral non-steroidal drugs,and ordered shoulder joint exercise;on the basis of group A,group B(32 cases)underwent internal heat needles skeletal muscle attachment point release.Visual analogue scale(VAS)score and Constant-Murley shoulder function score were compared between two groups before and 7,30,and 90 d after treatment;the clinical efficacy of two groups were compared,and the occurrence of adverse reactions during treatment was recorded.Results After treatment,VAS scores of both groups at each time point were significantly different from those before treatment,with statistical significance(P<0.05);VAS scores in group B at each time point were lower than those in group A,with statistical significance(P<0.05).After treatment,Constant-Murley shoulder function scores at each time point in both groups were significantly different from those before treatment,with statistical significance(P<0.05);Constant-Murley shoulder function scores at each time point in group B were lower than those in group A,with statistical significance(P<0.05).At 7,30,and 90 days after treatment,there were statistical significance in good improment rate between two groups(P<0.05).There were no complications such as nerve injury,local anesthetic poisoning,and injury of muscles and tendons around shoulder in both groups.Conclusion Ultrasound guided brachial plexus anesthesia manipulation rele

关 键 词：超声引导 臂丛麻醉 手法松解 内热针 骨骼肌松解 冻结肩 

分 类 号：R687.4[医药卫生—骨科学]