肌骨超声引导下针刀松解术治疗原发性冻结肩的研究  

Clinical study of musculoskeletal ultrasound-guided acupotomy for primary frozen shoulder

作　　者：张涛[1] 潘贵超[1] 石可松[1] 张晓哲 李旭尧 黄磊[1] 孟朋 焦权明[1] ZHANG Tao;PAN Gui-chao;SHI Ke-song(The Third Section of Orthopedics Department,Beijing Changping Hospital of Integrated Chinese and Western Medicine,Beijing 102208,China;不详)

机构地区：[1]北京市昌平区中西医结合医院骨三科,北京102208

出　　处：《中国医学装备》2022年第5期82-85,共4页China Medical Equipment

基　　金：北京市昌平卫生科技发展专项(中医药)课题计划(昌卫科2017-5-04)“肌骨超声引导下针刀松懈术治疗原发性冻结肩的疗效观察”。

摘　　要：目的:研究肌骨超声引导下针刀松解术治疗原发性冻结肩的疗效。方法:选取医院收治的96例原发性肩痛患者,按照随机数表法将其分为治疗组、对照组和空白组,每组32例。治疗组在肩关节功能锻炼(爬墙摸高及弯腰晃肩)的基础上采用肌骨超声引导下针刀松解术;对照组在肩关节功能锻炼的基础上采用单纯痛点针刀松解术;空白组仅进行肩关节功能锻炼。针对治疗组患者治疗前及治疗后4周,对超声下测量盂肱关节下方关节囊(IC)厚度及喙肱韧带(CHL)的厚度、肱二头肌长头腱(LHB)腱鞘积液量以及肩峰下-三角肌下滑囊(SASD)厚度情况进行比较分析,并对3组患者治疗前,治疗后2周及4周的疼痛视觉模拟评分(VAS)及Constant-Murley评分进行评价。结果:观察组和对照组患者治疗2周及4周后VAS疼痛评分较治疗前均有明显下降,差异有统计学意义(t_(观察组)=1.523,t=2.071;t_(对照组)=2.891,t=3.146;P<0.05),空白组患者VAS疼痛评分较治疗前差异无统计学意义;治疗后观察组患者的Constant-Murley评分较对照组和空白组有显著提高,差异有统计学意义(F=5.197,F=4.759;P<0.05)。观察组患者治疗4周后较治疗前IC及CHL厚度减低、LHB腱鞘及SASD厚度明显减少,差异有统计学意义(t=5.937,t=3.138,t=8.275,t=7.491;P<0.05)。结论:肌骨超声引导下特定部位的针刀松解术治疗原发性冻结肩的疗效显著,值得推广。Objective:To explore and analyze the curative effect of musculoskeletal ultrasound-guided acupotomy in treating primary frozen shoulder.Methods:96 patients with primary shoulder pain who admitted to hospital were randomly divided into treatment group,control group and blank group,with 32 cases in each group.All patients of three groups received functional exercise of shoulder joint(climbing wall,touching height,bending and shaking shoulder),and the treatment group adopted musculoskeletal ultrasound-guided acupotomy on the basis of functional exercise,and the control group adopted acupotomy at pain point on the basis of functional exercise,and black group only received functional exercise of shoulder joint.The thickness of the inferior glenohumeral joint capsule(IC),the thickness of the coracohumeral ligament(CHL),the effusion amount of tendon sheath fluid of the tendon of long head of biceps brachii(LHB),and the thickness of sub acromial-sub deltoid bursa(SASD)were measured under ultrasound of treatment group between before and 4 weeks after treatment were compared and analyzed.And the scores of visual analogue scale(VAS)and the scores of Constant-Murley of the patients of three groups were evaluated before treatment,2 weeks and 4 weeks after treatment.Results:VAS pain scores of observation and control group 2 weeks and 4 weeks after treatment were significantly lower than those before treatment(t_(observation group)=1.523,t=2.071,t_(control group)=2.891,t=3.146,P<0.05),respectively,while VAS pain score of blank group showed there was no significant difference between before and after treatment.After treatment,the Constant-Murley score of observation group was significantly higher than that of control group and blank group(F=5.197,F=4.759,P<0.05),respectively.Compared with those before treatment,the thicknesses of IC and CHL,the thicknesses of LHB tendon sheath and SASD were significantly reduced in observation group 4 weeks after treatment(t=5.937,t=3.138,t=8.275,t=7.491,P<0.05).Conclusion:Musculoskeletal ultras

关 键 词：原发性冻结肩 针刀 松解术 肌骨超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]