肩胛上神经阻滞联合任务导向训练治疗脑卒中后偏瘫肩痛的疗效观察  

The efficacy of suprascapular nerve block combined with task-oriented training in patients with hemiplegic shoulder pain

作　　者：黄小玉 赖丽萍 胡荣亮[1] HUANG Xiaoyu;LAI Liping;HU Rongliang(Department of Rehabilitation Medicine,Jiangmen Central Hospital,Jiangmen,Guangdong 529000,China)

机构地区：[1]江门市中心医院康复医学科,广东江门529000

出　　处：《医药前沿》2024年第14期13-16,共4页Journal of Frontiers of Medicine

基　　金：江门市科学技术局课题(2020YLA108)。

摘　　要：目的:探讨超声引导下肩胛上神经阻滞(SSNB)联合任务导向训练(TOT)对脑卒中后偏瘫肩痛(HSP)的疗效。方法:选取2020年4月—2023年6月江门市中心医院康复医学科收治的脑卒中后偏瘫患者47例为研究对象,根据治疗方案不同分为对照组(26例)和研究组(21例)。两组均进行TOT,研究组患者在TOT前先进行SSNB,两组再进行TOT,连续治疗12周。比较两组患者治疗前、治疗4周、治疗12周的视觉模拟评分法(VAS)、简化Fugl-Meyer运动功能评分法-上肢部分(FMA-UE)、改良Barthel指数(MBI)评分。结果:VAS评分在时间与治疗方法之间存在交互效应(P交互<0.05);时间、治疗方法在VAS评分主效应显著(P<0.05)。两组治疗后4周、12周VAS评分均低于治疗前,差异有统计学意义(P<0.05),研究组治疗后4周、12周VAS评分低于对照组,差异有统计学意义(P<0.05)。FMA-UE评分在时间与治疗方法之间存在交互效应(P交互<0.05);时间、治疗方法在FMA-UE评分主效应显著(P<0.05)。两组治疗后4周、12周FMA-UE评分均高于治疗前,差异有统计学意义(P<0.05),两组治疗后4周、12周FMA-UE评分比较,差异无统计学意义(P>0.05)。MBI评分在时间与治疗方法之间不存在交互效应(P交互>0.05);时间、治疗方法在MBI评分主效应不显著(P>0.05)。两组治疗后4周、12周MBI评分均高于治疗前,差异有统计学意义(P<0.05);两组治疗后4周、12周MBI评分比较,差异无统计学意义(P>0.05)。结论:SSNB联合TOT有助于缓解HSP症状,利于患者进行上肢运动功能训练。Objective To investigate the efficacy of ultrasound-guided suprascapular nerve block(SSNB)combined with task-oriented training(TOT)in patients with hemiplegic shoulder pain(HSP).Methods 47 patients with HSP,admitted to the Department of Rehabilitation Medicine of Jiangmen Central Hospital from April 2020 to June 2023,were divided into the control group(26 patients)and the study group(21 patients).The study group underwent SSNB,then both groups underwent 12-week TOT.Visual Analogue Scale(VAS),Score of Fugl-Meyer Assessment-Upper Extremity(FMA-UE)and Modified Barthel Index(MBI)were compared between two groups before treatment,4 weeks after treatment,and 12 weeks after treatment.Results There was an interaction effect between time and treatment on VAS score(Pinteraction<0.05).The main effect of time and treatment method on VAS score was significant(P<0.05).The VAS scores of the two groups at 4 and 12 weeks after treatment were lower than those before treatment,and the difference was statistically significant(P<0.05).The VAS scores of the study group at 4 and 12 weeks after treatment were lower than those of the control group,and the difference was statistically significant(P<0.05).There was an interaction effect between time and treatment method in FMA-UE score(Pinteraction<0.05).The main effect of time and treatment method on FMA-UE score was significant(P<0.05).The FMA-UE scores of the two groups at 4 and 12 weeks after treatment were higher than those before treatment,and the difference was statistically significant(P<0.05).There was no significant difference in FMA-UE scores between the two groups at 4 and 12 weeks after treatment(P>0.05).There was no interaction between time and treatment method in MBI score(Pinteraction>0.05).The main effect of treatment time and treatment method on MBI score was not significant(P>0.05).The MBI scores of the two groups at 4 and 12 weeks after treatment were higher than those before treatment,and the difference was statistically significant(P>0.05).Conclusions SSNB combined wit

关 键 词：脑卒中 偏瘫肩痛 肩胛上神经阻滞 任务导向训练 

分 类 号：R743[医药卫生—神经病学与精神病学]