超声引导下肩关节腔内注射玻璃酸钠治疗偏瘫肩痛的疗效分析  

Efficacy of sonography-guided intraarticular injection of hyaluronic acid for hemiplegic shoulder pain

作　　者：张芳[1] 沈华良[2] 沈晶晶 陈争一[1] 宣丹艳 龚剑秋[1] ZHANG Fang;SHEN Hualiang;SHEN Jingjing;CHEN Zhengyi;XUAN Danyan;GONG Jianqiu(Department of Rehabilitation,Shaoxing People's Hospital,Shaoxing 312000,China;不详)

机构地区：[1]绍兴市人民医院康复科,312000 [2]绍兴市人民医院超声影像科,312000

出　　处：《浙江医学》2023年第1期72-75,79,共5页Zhejiang Medical Journal

基　　金：浙江省卫生健康科技计划青年创新人才项目(2022RC276);浙江省康复医学会临床科研基金项目(2021KF005)。

摘　　要：目的探讨超声引导下肩关节腔内注射玻璃酸钠治疗偏瘫肩痛的疗效。方法选取2020年5月至2021年12月在绍兴市人民医院康复科住院治疗的偏瘫肩痛患者41例,按随机数字表法分为观察组21例,对照组20例。对照组给予常规康复训练和超短波治疗,观察组给予常规康复训练和超声引导下患侧肩关节腔内玻璃酸钠+利多卡因注射治疗,治疗前后通过视觉模拟评分法(VAS),肩关节被动前屈、外展、外旋关节活动度及上肢Fugl-Meyer运动功能评定量表(FMA-U)评定疗效。结果与同组治疗前比较,两组患者治疗后VAS评分、肩关节被动前屈、外展、外旋角度及FMA-U评分均改善,差异均有统计学意义(均P<0.01)。两组患者治疗后FMA-U评分、肩关节被动前屈、外展、外旋角度比较差异均有统计学意义(均P<0.05)。结论超声引导下肩关节腔内注射玻璃酸钠治疗可有效提高偏瘫肩痛患者被动关节活动度,缓解肩痛,提高上肢运动功能,可适用于有糖尿病的偏瘫肩痛患者。Objective To evaluate the efficacy of sonography-guided intraarticular injection of hyaluronic acid for patients with hemiplegic shoulder pain.Methods Forty-one patients with hemiplegic shoulder pain who were admitted in Shaoxing People’s Hospital from May 2020 to December 2021 were randomly divided into two groups:20 patients were given conventional rehabilitation and ultrashort wave treatments(control group),and 21 patients received sonographyguided intraarticular injection of hyaluronic acid on the basis of conventional rehabilitation treatment(study group).Visual analogue scale(VAS),the range of forward flexion,abduction and external rotation in the shoulder and the Fugl-Meyer motor function assessment-upper extremity(FMA-U)were assessed before and after treatment.Results The VAS score,range of forward flexion,abduction and external rotation of shoulder and FMA-U were significantly improved after treatment in both groups(all P<0.01);while the FMA-U,the angle of forward flexion,abduction and external rotation angles of shoulder in study group were significantly better than those in control group(all P<0.05).Conclusion Compared with conventional rehabilitation intra-articular injection of hyaluronic acid under the sonography is more effective to increase the ranges of motion of shoulder,reduce the pain and improve the function of the arm in patients with hemiplegic shoulder pain.

关 键 词：超声 中风 偏瘫肩痛 玻璃酸钠 

分 类 号：R743.3[医药卫生—神经病学与精神病学]