综合康复治疗在不同类型肩关节周围炎患者中的疗效观察  

The efficacy of comprehensive rehabilitation treatment on patients with different types of scapulohumeral periarthritis

作　　者：朱得婷 李凯 周云[1] 王永召[1] 熊斌[1] 张全兵[1] ZHU Deting;LI Kai;ZHOU Yun;WANG Yongzhao;XIONG Bin;ZHANG Quanbing(Department of Rehabilitation Medicine,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601)

机构地区：[1]安徽医科大学第二附属医院康复医学科,合肥230601

出　　处：《颈腰痛杂志》2025年第1期45-49,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：安徽省卫生健康科研项目(AHWJ2022b063);安徽医科大学2022年临床医学学科建设项目(2022 lcxkEFY010);安徽医科大学高峰学科(临床医学)学科建设项目(2022GFXK-EFY08);安徽医科大学2023年学科建设项目(2023lcxkEFY010)。

摘　　要：目的观察综合康复治疗在不同类型肩关节周围炎患者中的疗效,分析可能原因。方法选择2021年12月至2023年3月就诊于安徽医科大学第二附属医院康复医学科的75例肩关节周围炎患者,根据发病原因不同分为原发组29例,继发非手术组27例,继发手术组19例,三组患者予以相同康复治疗方案,评估治疗前、治疗后的视觉模拟评分(VAS)、关节活动度及疗效、不良反应和生存分析。结果治疗结束后,三组患者VAS均较治疗前下降(P<0.05),但三组之间VAS改善程度无明显区别(P>0.05)。治疗结束后,三组患者肩关节活动度均较治疗前增加(P<0.05),其中,原发组优于继发非手术组,继发非手术组优于继发手术组(P<0.05)。治疗结束后,总有效率原发组为82.76%,继发非手术组为74.08%,继发手术组为42.10%,三组之间差异有统计学意义(P<0.05),其中,原发组优于继发手术组(P<0.017)。75例患者有4例(5.33%)在首次冲击波治疗后发生疼痛加重,可自行缓解,所有患者均无严重不良反应。治疗结束1个月后对所有患者进行随访,发生终点事件共有7例(9.33%)。其中,原发组有1例(占原发组人数3.44%),继发非手术组有4例(占继发非手术组人数15%),继发手术组有2例(占继发手术组人数10.53%),三组之间差异无统计学意义(P>0.05)。结论无论何种原因导致肩关节周围炎发生,予以综合康复治疗均能得到有效改善,短期再发概率低,鼓励所有患者尽早积极康复。综合各项指标来看,原发组患者肩关节功能改善程度优于继发非手术组,继发非手术组优于继发手术组。Objective To observe the curative effect of comprehensive rehabilitation therapy on patients with different types of scapulohumeral periarthritis and analyze the possible causes.Methods From December 2021 to March 2023,75 patients with scapulohumeral periarthritis in the Second Affiliated Hospital of Anhui Medical University were selected and divided into the primary group(n=29),the secondary non-operation group(n=27),and the secondary operation group(n=19)according to the different causes of the disease.The three groups received the same rehabilitation treatment plan.They were evaluated on the visual analogue scale(VAS),joint range of motion(ROM),efficacy,adverse reactions,and survival analysis before and after treatment.Results Compared with before treatment,VAS was significantly relieved in all three groups after treatment(P<0.05),and there was no significant difference in the improvement of VAS between the three groups(P>0.05).Compared with before treatment,joint ROM was obviously improved in all three groups after treatment(P<0.05),the primary group was better than the secondary non-operation group,and the secondary non-operation group was better than the secondary operation group.After treatment,the total effective rate was 82.76%in the primary group,74.08%in the secondary non-operation group,and 42.10%in the secondary operation group,and the difference between the three groups was statistically significant(P<0.05),among which the primary group was better than the secondary operation group(P<0.017).Among the 75 patients,4(5.33%)had aggravated pain after the first shock wave treatment,which was relieved spontaneously,and all patients had no serious adverse reactions.All patients were followed up one month after the treatment,and 7 patients(9.33%)had an endpoint event.Among them,there was 1 case in the primary group(3.44%in the primary group),4 cases in the secondary non-operation group(15%in the secondary non-operation group),and 2 cases in the secondary operation group(10.53%in the secondary operation group

关 键 词：肩关节周围炎 分型 康复治疗 疗效 关节活动度 疼痛 

分 类 号：R493[医药卫生—康复医学]