高电压脉冲射频联合术中改良舒筋手法及关节穿刺注射治疗97例肩关节粘连患者的临床观察  

Clinical Effect of High-Voltage Pulsed Radiofrequency Combined with Modified Tendon-Relaxing Manipulation and Joint Cavity Injection in Treating 97 Cases of Shoulder Joint Adhesion

作　　者：王杰伟 李阳[2] 杨屾[1] 臧鹏 王志鹏[2] WANG Jie-wei;LI Yang;YANG Shen;ZANG Peng;WANG Zhi-peng(The Fourth Department of Orthopedics,Department of Neck,Shoulder,Waist,and Leg Pain,Changping Hospital of Integrated Chinese and Western Medicine,Beijing 102208;Office of Doctor-Patient Disputes,Changping Hospital of Integrated Chinese and Western Medicine,Beijing 102208)

机构地区：[1]北京市昌平区中西医结合医院骨四科,颈肩腰腿疼痛科,北京102208 [2]北京市昌平区中西医结合医院医患办,北京102208

出　　处：《世界中西医结合杂志》2023年第8期1650-1655,共6页World Journal of Integrated Traditional and Western Medicine

摘　　要：目的 探索高电压脉冲射频联合术中改良舒筋手法及关节穿刺注射治疗肩关节粘连的临床疗效。方法 选取2019年2月—2021年7月期间北京市昌平区中西医结合医院颈肩腰腿疼痛科住院的97例肩关节疼痛伴活动受限患者。根据治疗方式不同分为观察组27例、对照1组24例、对照2组24例和对照3组22例。观察组采用肩胛上神经(Suprascapular nerve,SSN)肩关节腔内高电压脉冲射频联合术中舒筋手法及关节穿刺注射,对照1组采用高电压脉冲射频联合术中舒筋手法,对照2组采用高电压脉冲射频联合关节穿刺注射,对照3组采用肩关节穿刺注射治疗联合舒筋手法。治疗3个月后,观察比较4组患者临床疗效、复发情况,治疗前后视觉模拟评分(Visual analogue scores,VAS)、牛津大学肩关节评分(Oxford shoulder score,OSS)及肩关节功能Constant Murley评分(CMS评分)。结果 治疗2 d、1周、2周、1个月、3个月后4组患者VAS评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组VAS评分均低于对照1、2、3组,差异有统计学意义(P<0.05);对照1组、对照3组治疗后各时间节点VAS评分均低于对照2组,差异有统计学意义(P<0.05)。治疗2 d、1周、2周、1个月、3个月后4组患者CMS评分均较治疗前升高,差异有统计学意义(P<0.05);且观察组治疗后CMS评分均较对照1、2、3组,差异有统计学意义(P<0.05);对照1组、对照3组治疗1周、2周、1个月、3个月后CMS评分均高于对照2组,差异有统计学意义(P<0.05)。治疗2 d、1周、2周、1个月、3个月后4组患者OSS评分均较治疗前升高,差异有统计学意义(P<0.05);且观察组治疗后OSS评分均高于对照1、2、3组,差异有统计学意义(P<0.05);对照1组、对照3组治疗1周、2周、1个月、3个月后OSS评分均高于对照2组,差异有统计学意义(P<0.05)。治疗后观察组总有效率为96.30%(26/27),对照1组总有效率为87.50%(21/24),对照2组总有效率为70Objective To explore the clinical effect of high-voltage pulsed radiofrequency combined with modified tendon-relaxing manipulation and joint cavity injection in the treatment of shoulder joint adhesion.Methods A total of 97 patients with shoulder joint pain and limited mobility treated in the Department of Neck,Shoulder,Waist,and Leg Pain,Changping Hospital of Integrated Chinese and Western Medicine from February 2019 to July 2021 were selected.According to different treatment methods,the patients were assigned into an observation group(n=27)and control groups 1(n=24),2(n=24),and 3(n=22).The observation group was treated with high-voltage pulsed radiofrequency for the suprascapular nerve(SSN)in the shoulder joint cavity combined with tendon-relaxing manipulation and joint cavity injection.The control groups 1,2,and 3 were treated with high-voltage pulsed radiofrequency combined with intraoperative tendon-relaxing manipulation,high-voltage pulsed radiofrequency combined with joint cavity injection,and joint cavity injection combined with tendon-relaxing manipulation,respectively.The treatment lasted for 3 months,and the clinical efficacy and recurrence were compared among the four groups.The visual analog scale(VAS)score,Oxford shoulder score(OSS),and Constant-Murley score(CMS)were assessed before and after treatment.Results After 2 days,1 week,2 weeks,1 month,and 3 months of treatment,the VAS scores of all the four groups decreased(P<0.05).The VAS score in the observation group was lower than those in the control groups 1,2,and 3(P<0.05),and the VAS score in the control groups 1 and 3 were lower than that in the control group 2(P<0.05).After 2 days,1 week,2 weeks,1 month,and 3 months of treatment,OSS and CMS in all the four groups increased(P<0.05).Moreover,the observation group had higher OSS and CMS than the control groups 1,2,and 3(P<0.05).The control groups 1 and 3 had higher OSS and CMS than the control group 2 after treatment for 1 week,2 weeks,1 month,and 3 months(P<0.05).The total response rates in the ob

关 键 词：肩关节 肩周炎 粘连 脉冲 高电压 射频 手法 穿刺 

分 类 号：R684.8[医药卫生—骨科学]