超声引导下SASD药物注射联合聚焦式体外冲击波治疗肩峰下撞击综合征的临床疗效  

Clinical effect of ultrasound-guided drug injection into the subacromialsubdeltoid bursa combined with focused extracorporeal shock wave therapy on subacromial impingement syndrome

作　　者：乔源鑫 杨阳 宋子民 张荣方 QIAO Yuan-xin;YANG Yang;SONG Zi-min;ZHANG Rong-fang

机构地区：[1]南阳市中医院运动医学科,河南南阳473000 [2]南阳市中医院冲击波治疗室,河南南阳473000

出　　处：《中国疗养医学》2024年第10期89-93,共5页Chinese Journal of Convalescent Medicine

摘　　要：目的探讨超声引导下肩峰下-三角肌下滑囊(SASD)药物注射联合聚焦式体外冲击波治疗肩峰下撞击综合征(SIS)患者的临床疗效。方法选取南阳市中医院2020年1月至2023年12月收治的70例SIS患者,根据治疗方案不同分为冲击波组和SASD注射组,各35例。冲击波组采用聚焦式体外冲击波治疗,SASD注射组在冲击波治疗基础上联合超声引导下SASD注射复方倍他米松和利多卡因治疗。比较两组临床总有效率、治疗前后肩关节功能评分[Constant-Murley功能评分(CMS)]、疼痛介质[5-羟色胺(5-HT)、前列腺素E2(PGE2)]水平及疼痛视觉模拟评分(VAS)、血清炎症因子[白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]及不良反应。结果治疗后,SASD注射组临床总有效率97.14%高于冲击波组77.14%(P<0.05);治疗后,SASD注射组CMS评分高于冲击波组、VAS评分低于冲击波组(P<0.05);治疗后,SASD注射组血清5-HT、PGE2、IL-1、IL-6、TNF-α水平均低于冲击波组(P<0.05);治疗期间,SASD注射组不良反应发生率14.29%与冲击波组8.57%相比,差异无统计学意义(P>0.05)。结论超声引导下SASD药物注射联合聚焦式体外冲击波治疗SIS患者临床疗效显著,可有效抑制炎症反应,缓解患者肩部疼痛程度,改善肩关节功能,有助于病情康复。Objective To investigate the clinical effect of ultrasound-guided drug injection into the subacromialsubdeltoid bursa(SASD)combined with focused extracorporeal shock wave therapy on subacromial impingement syndrome(SIS).Methods A total of 70 SIS patients admitted to Nanyang TCM Hospital from January 2020 to December 2023 were selected.They were assigned into shock wave group and SASD injection group according to different treatment plans,with 35 cases in each group.Patients in the shock wave group were treated with focused extracorporeal shock wave therapy,and those in the SASD injection group were treated with ultrasound-guided injection of compound betamethasone and lidocaine into the SASD plus shock wave therapy.The total clinical response rate,the Constant-Murley shoulder outcome score(CMS),pain mediators(5-hydroxy tryptamine[5-HT],prostaglandin E2[PGE2]),visual analogue score(VAS),serum inflammatory factors(interleukin-1[IL-1],interleukin-6[IL-6],tumor necrosis factor-α[TNF-α])and adverse reactions were compared between the two groups.Results After treatment,the total effective rate of SASD injection group was significantly higher than that of shock wave group(97.14%VS 77.14%,P<0.05).The CMS score of SASD injection group was significantly higher than that of shock wave group,while the VAS score was significantly lower(P<0.05).Serum levels of 5-HT,PGE2,IL-1,IL-6 and TNF-αin SASD injection group were significantly lower than those of shock wave group(P<0.05).During treatment,there was no significant difference in the incidence of adverse reactions between the SASD injection group and the shock wave group(14.29%VS 8.57%,P>0.05).Conclusion Ultrasound-guided drug injection into the SASD combined with focused extracorporeal shock wave therapy for SIS patients has a significant clinical efficacy,which can effectively inhibit inflammation,relieve shoulder pain,improve shoulder joint function,and contribute to the rehabilitation of SIS patients.

关 键 词：肩峰下撞击综合征 肩峰下-三角肌下滑囊 复方倍他米松 聚焦式体外冲击波 

分 类 号：R873[医药卫生—运动医学]