超声引导下液压扩张联合松解手法治疗原发性冻结肩的临床研究  

Clinical study of ultrasound-guided hydraulic expansion combined with loosening manipulation in treatment of primary frozen shoulder

作　　者：朱媛[1] 贾玄慧[1] 商静 郑瑜欣 刘波[1] 王珍芳[1] ZHU Yuan;JIA Xuanhui;SHANG Jing;ZHENG Yuxin;LIU Bo;WANG Zhenfang(Department of Ultrasound Diagnosis Center,Shaanxi Provincial People’s Hospital,Xi’an 710068,China.)

机构地区：[1]陕西省人民医院超声诊断中心,陕西西安710068

出　　处：《中国中西医结合影像学杂志》2023年第2期180-183,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：陕西省重点研发项目——社会发展领域项目(2018SF-164)。

摘　　要：目的:评价超声实时引导下盂肱关节后隐窝入路液压扩张关节囊联合松解手法治疗原发性冻结肩的有效性及安全性。方法:选择原发性冻结肩患者75例(共80个患肩)为研究对象,随机分为试验组(35例,40个患肩)和对照组(40例,40个患肩)。试验组采用超声引导下盂肱关节后隐窝入路液压扩张关节囊联合手法松解治疗,对照组仅行超声引导下盂肱关节后隐窝入路液压扩张。患者治疗后4周分别采用视觉模拟量表(VAS)、Constant-Murley肩关节功能评分及美国加州大学洛杉矶分校(UCLA)肩关节功能评分评定治疗的有效性及安全性。结果:试验组治疗总有效率高于对照组(P<0.05)。治疗前,2组患者VAS评分、Constant-Murley评分及UCLA评分比较,差异均无统计学意义(均P>0.05)。治疗后,2组肩关节VAS评分低于治疗前,且试验组低于对照组(均P<0.05);治疗后Constant-Murley评分及UCLA评分均高于治疗前,且试验组均高于对照组(均P<0.05)。所有患者均在超声引导下一次性穿刺成功,治疗过程中均耐受,未发生明显不适及并发症。结论:超声引导下实时液压扩张盂肱关节囊联合松解手法治疗原发性冻结肩安全、有效,能为临床选择治疗方案提供参考。Objective:To evaluate the effectiveness and safety of the treatment of primary frozen shoulder with hydraulic expansion of the joint capsule under real-time ultrasound guidance combined with the loosening manipulation of the glenohumeral joint.Methods:75 cases of frozen shoulder were randomly divided into the experimental group(35 cases with 40 shoulders)and the control group(40 cases with 40 shoulders).The experimental group was treated with ultrasound-guided posterior glenohumeral joint capsule hydraulic expansion combined with loosening manipulation,while the control group was treated only with ultrasound-guided hydrolysis of the posterior glenoid capsule.After 4 weeks of treatment,the effectiveness and safety of the treatment was assessed by visual analogue scale(VAS),Constant-Murley score and UCLA score.Results:The total effective rate of experimental group was higher than that of control group(P<0.05).The differences in VAS,Constant-Murley and UCLA score between the two groups were not statistically significant before treatment(all P>0.05).After treatment,VAS scores of two groups were lower than before treatment and that of the experimental group was lower than that of the control group(all P<0.05);Constant-Murley and UCLA score were higher than before treatment,and those of the experimental group were higher than those of the control group(all P<0.05).All patients had a successful one-time puncture under the guidance of ultrasound,and all patients tolerated the treatment with no apparent discomfort and no complications.Conclusions:Real-time hydraulic expansion of the glenohumeral joint capsule under ultrasound guidance combining with loosening manipulation is safe and effective for the treatment of frozen shoulder,which provides a reference for clinical selection of treatment options.

关 键 词：液压扩张 冻结肩 手法松解 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R684[医药卫生—诊断学]