超声引导下肩袖间隙与痛点注射消炎镇痛混合液治疗肩袖损伤的效果比较  

Comparison of the effects of ultrasound-guided injection of anti-inflammatory and analgesic mixture into the rotator cuff space and pain points in the treatment of rotator cuff injuries

作　　者：单玲玲 徐琼 王鹏飞 张丽 杜信 杜奋飞 SHAN Lingling;XU Qiong;WANG Pengfei;ZHANG Li;DU Xin;DU Fenfei(Rehabilitation Department of Dongyang People's Hospital,Jinhua,Zhejiang 322100,China)

机构地区：[1]东阳市人民医院康复科,浙江金华322100

出　　处：《中华全科医学》2023年第8期1393-1396,1420,共5页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2022ZH065);金华市科学技术局科技计划项目(2022-3-026)。

摘　　要：目的肩关节注射疗法作为肩袖损伤的主要治疗手段,可分为超声引导下肩袖间隙与传统痛点注射治疗,本研究主要比较二者的效果差异。方法选取2020年4月-2022年10月在东阳市人民医院接受肩关节注射治疗的92例肩袖损伤患者,采用随机数字表法分为超声引导注射组(46例)和传统痛点注射组(46例),分别在超声引导下肩袖间隙、依据传统痛点注射法进行消炎镇痛混合液注射,均每2周1次,持续注射3次。比较2组治疗前后视觉模拟疼痛(VAS)评分、血清C-反应蛋白(CRP)、肩关节Constant-Murley评分、需口服镇痛药物及皮下瘀斑发生率。结果2组治疗2、4、6周VAS评分和血清CRP水平均低于治疗前(均P<0.05),且超声引导注射组上述时间点VAS评分和血清CRP水平均显著低于传统痛点注射组(均P<0.05)。2组治疗2、4、6周肩关节Constant-Murley评分均高于治疗前(均P<0.05),且超声引导注射组治疗4、6周肩关节Constant-Murley评分明显高于传统痛点注射组(均P<0.05)。超声引导注射组口服镇痛药物占21.74%(10/46)低于传统痛点注射组的41.30%(19/46,P<0.05);组间皮下瘀斑发生率比较差异无统计学意义(P>0.05)。结论超声引导下肩袖间隙与痛点注射消炎镇痛混合液治疗肩袖损伤均有较好的效果,但前者在减轻肩袖疼痛、下调血清CRP水平、改善肩关节功能和减少口服镇痛药物方面有明显优势。Objective Shoulder joint injection therapy,as the main treatment for rotator cuff injuries,can be divided into ultrasound-guided rotator cuff space injection therapy and traditional pain point injection therapy.This study mainly compares the therapeutic differences between the two treatments.Methods From April 2020 to October 2022,92 patients with rotator cuff injury who received conservative treatment with drug injection in Dongyang People's Hospital were divided into ultrasound-guided injection group(n=46)and traditional pain spot injection group(n=46)using the random number table method.The anti-inflammatory and analgesic mixture was injected into the rotator cuff space under ultrasound guidance and according to the traditional pain spot injection method once every 2 weeks and continuously 3 times,respectively.The visual analogue pain(VAS)score,serum C-reactive protein(CRP),Constant Murley shoulder joint score,need for oral analgesics and incidence of subcutaneous ecchymosis were compared between the two groups before and after treatment.Results VAS scores and serum CRP levels were lower in the two groups at 2,4 and 6 weeks of treatment than before treatment(all P<0.05),and VAS scores and serum CRP levels at the above-mentioned time points were significantly lower in the ultrasound guided injection group than in the traditional pain point injection group(all P<0.05).The shoulder joint Constant-Murley score in the two groups at 2,4,6 weeks of treatment was higher than that before treatment(all P<0.05),and the shoulder joint Constant-Murley score in the ultrasound-guided injection group at 4,6 weeks of treatment was significantly higher than that in the traditional pain point injection group(all P<0.05).In the ultrasound-guided injection group,21.74%(10/46)of oral analgesic drugs were less than 41.30%(19/46)in the traditional pain point injection group(P<0.05),and there was no statistically significant difference in the incidence of subcutaneous ecchymosis between groups(P>0.05).Conclusion Ultrasound-guided inje

关 键 词：肩袖损伤 超声引导 肩袖间隙 痛点注射法 

分 类 号：R681.7[医药卫生—骨科学] R493[医药卫生—外科学]