FEAR技术或单纯外展技术麻醉下手法松解治疗原发性冻结肩的疗效比较  

Comparison of the efficacy of manipulation under anesthesia with FEAR or simple abduction in the treatment of primary frozen shoulder

作　　者：许连荣 王昆[2] 宋成军[2] 李成文 Xu Lianrong;Wang Kun;Song Chengjun;Li Chengwen(Department of Pain Management,Jinxiang People′s Hospital,Jining 272200,China;Department of Anesthesiology,Jining No.1 People′s Hospital,Jining 272011,China;Department of Anesthesiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]金乡县人民医院疼痛科,济宁272200 [2]济宁市第一人民医院麻醉科,济宁272011 [3]首都医科大学附属北京友谊医院麻醉科,北京100050

出　　处：《国际麻醉学与复苏杂志》2024年第7期702-707,共6页International Journal of Anesthesiology and Resuscitation

摘　　要：目的比较FEAR技术和单纯外展技术用于麻醉下手法松解(MUA)治疗原发性冻结肩(PFS)的临床效果和安全性。方法将70例PFS患者采用随机数字表法分为FEAR技术组(F组)和单纯外展技术组(A组)。F组MUA操纵手法采用FEAR技术,A组MUA操纵手法采用单纯外展技术。所有患者的MUA均在C6神经根阻滞下实施,并在MUA后接受肩关节腔激素注射治疗。记录治疗前和治疗后1、2、4周的肩痛和残疾指数(SPADI)评分和被动关节活动度(ROM),记录治疗后1、2、4周和3个月随访的患者整体印象改变(GIC)评分,并记录再次MUA情况、MUA治疗相关严重不良事件及3个月随访期间接受其他治疗情况。结果两组治疗前和治疗后1、2、4周SPADI疼痛评分、残疾评分、总分及被动ROM(上举、外展、外旋、内旋)差异均无统计学意义(均P>0.05)。与治疗前比较,治疗后1、2、4周两组SPADI疼痛评分、残疾评分、总分明显降低(均P<0.05),被动ROM(上举、外展、外旋、内旋)明显增加(均P<0.05);与治疗后1周比较,治疗后2周两组SPADI残疾评分、总分及F组SPADI疼痛评分降低(均P<0.05),治疗后4周两组SPADI疼痛评分、残疾评分和总分降低(均P<0.05),治疗后2、4周两组被动ROM(上举、外展、外旋、内旋)增加(均P<0.05);与治疗后2周比较,治疗后4周两组SPADI疼痛评分、总分及F组SPADI残疾评分降低(均P<0.05),两组被动ROM(上举、外展、外旋、内旋)增加(均P<0.05)。两组治疗后1、2、4周和3个月随访GIC评分差异均无统计学意义(均P>0.05)。与治疗后1周比较,治疗后4周和3个月随访两组GIC评分降低(均P<0.05);与治疗后2周比较,治疗后4周和3个月随访A组GIC评分均降低(均P<0.05)。F组和A组治疗后1周的显著改善率(GIC=1分)分别为66.7%和59.4%(P>0.05),且两组3个月随访时的显著改善率均为100%。两组均未发生MUA治疗相关严重不良事件,两组再次MUA例数及3个月随访期间接受其他治疗例�ObjectiveTo compare the clinical effect and safety of manipulation under anesthesia(MUA)using FEAR or simple abduction in patients with primary frozen shoulder(PFS).MethodsA total of 70 PFS patients were divided into two groups:a FEAR group(group F)or a simple abduction group(group A),according to the random number table method.The FEAR was used for MUA in group F,and simple abduction was used in group A.MUA was performed under C 6 nerve root block,and intra-articular steroid was injected following MUA in all participants.The shoulder pain and disability index(SPADI)and the passive range of motion(ROM)were measured before operation,and 1,2,and 4 weeks after treatment.The Patients'Global Impression Change score(GIC)score was recorded 1,2,and 4 weeks and 3 months after treatment.Furthermore,the incidences of re-MUA and MUA-treatment-related serious adverse events,and other treatments received during the 3-month follow-up period were also recorded.ResultsThere were no statistical differences in SPADI pain score,disability score,total score and passive ROM(forward elevation,abduction,external rotation and internal rotation)between the two groups before treatment and 1,2 and 4 weeks after treatment(all P>0.05).Compared with those before treatment,SPADI pain score,disability score and total score significantly decreased(all P<0.05),and passive ROM(forward elevation,abduction,external rotation and internal rotation)significantly increased(all P<0.05)1,2 and 4 weeks after treatment.Compared with 1 week after treatment,both groups showed decreases in SPADI disability score and total score and group F presented reduced SPADI pain score 2 weeks after treatment(all P<0.05);both groups showed decreases in SPADI pain score,disability score and total score 4 weeks after treatment(all P<0.05);passive ROM(forward elevation,abduction,external rotation and internal rotation)increased in both groups 2 and 4 weeks after treatment(all P<0.05).Compared with 2 weeks after treatment,both groups showed decreases in SPADI pain score and to

关 键 词：冻结肩 麻醉下手法松解 神经阻滞 关节腔注射 

分 类 号：R614[医药卫生—麻醉学]