序贯注射曲安奈德联合玻璃酸钠治疗肩手综合征的临床疗效  

Clinical Efficacy of Sequential Injection of Triamcinolone Acetonide Combined with Sodium Hyaluronate in the Treatment of Shoulder-hand Syndrome

作　　者：闫源渊 张雪玉[2] YAN Yuanyuan;ZHANG Xueyu(Department of Pharmacy,Weinan First Hospital,Weinan Shaanxi 714000)

机构地区：[1]渭南市第一医院药剂科,陕西渭南714000 [2]延安大学附属医院胃肠疝外科,陕西延安716000

出　　处：《医学临床研究》2023年第11期1710-1712,1716,共4页Journal of Clinical Research

摘　　要：【目的】探讨关节腔内序贯注射曲安奈德联合玻璃酸钠治疗肩手综合征的临床疗效。【方法】选择2019年7月至2021年2月渭南市第一医院收治的92例脑卒中后肩手综合征患者,根据治疗方案不同将其分为观察组(n=47)和对照组(n=45),其中对照组采用关节腔注射玻璃酸钠治疗,观察组采用关节腔内序贯注射曲安奈德联合玻璃酸钠治疗。治疗7周后,比较两组患者肩手部运动功能、肩手疼痛评分、肩关节活动范围、手腕部水肿体积及不良反应发生状况。【结果】治疗后,两组患者运动功能评定量表(FMA)及综合功能评定量表(FCA)评分较治疗前均升高,视觉模拟量表(VAS)评分较治疗前均降低,且观察组FMA评分及FCA评分均高于对照组,VAS评分低于对照组(P<0.05);治疗后,两组患者肩关节活动范围较治疗前均增大,手腕部水肿体积较治疗前均缩小,且观察组肩关节活动范围大于对照组,手腕部水肿体积小于对照组(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】关节腔内序贯注射曲安奈德联合玻璃酸钠治疗肩手综合征患者,可有效改善患者上肢运动功能,减轻疼痛,且安全性良好。【Objective】To investigate the clinical efficacy of sequential injection of triamcinolone acetonide combined with sodium hyaluronate in the treatment of shoulder-hand syndrome after Stroke.【Methods】Ninety-two patients with shoulder-hand syndrome admitted to Weinan First Hospital from July 2019 to February 2021 were selected and divided into observation group(n=47)and control group(n=45)according to different treatment schemes.The control group was treated with intra-articular injection of sodium hyaluronate,while the observation group was treated with sequential intra-articular injection of triamcinolone acetonide combined with sodium hyaluronate.After 7 weeks of treatment,the motor function,shoulder-hand pain score,shoulder joint activity range,wrist edema volume,and adverse reactions were compared between the two groups.【Results】After treatment,the scores of motor function assessment scale(FMA)and comprehensive function assessment scale(FCA)in both groups were higher than those before treatment,while the visual analogue scale(VAS)scores were lower than those before treatment.The FMA and FCA scores in the observation group were higher than those in the control group,while the VAS score was lower than that in the control group(P<0.05).After treatment,the shoulder joint activity range in both groups increased compared with that before treatment,while the wrist edema volume decreased compared with that before treatment.The shoulder joint activity range in the observation group was greater than that in the control group,while the wrist edema volume was less than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).【Conclusion】Sequential intra-articular injection of triamcinolone acetonide combined with sodium hyaluronate can effectively improve the upper limb motor function and relieve pain in patients with shoulder-hand syndrome after stroke,and it is safe and reliable.

关 键 词：反射性交感神经营养障碍/药物疗法 曲安奈德/药理学 透明质酸/药理学 

分 类 号：R74[医药卫生—神经病学与精神病学]