摘要
目的：比较关节镜松解术后采用常规康复方法及结合应用手法治疗难治性肩凝症的疗效,评价手法治疗的应用价值.方法：自2007年3月至2010年7月,对符合肩凝症诊断标准、接受关节镜下粘连松解术的48例48肩（左肩23例,右肩25例）,分为手法治疗组和常规康复治疗组.常规康复治疗组26例,男11例,女15例;手法治疗组22例,男9例,女13例.手法治疗组除术后常规康复外接受手法推拿干预,手法治疗原则初期为活血止痛,后期为松解粘连、滑利关节,推拿治疗时间每次20 min,每日2次,共治疗10d.对所有患者进行随访,记录术前、术后各随访点的ASES评分及肩关节活动范围.结果：48例均获随访,时间4～25个月,平均（12.54±5.78）个月.术后1个月时,手法治疗组ASES评分和肩关节前屈活动度优于常规康复治疗组,末次随访时两组的各项随访指标差异均无统计学意义.结论：关节镜松解术结合术后手法治疗,有助于加快肩凝症患者的早期康复进程,帮助其尽早重返社会,但其远期关节功能与术后常规康复治疗相比无明显差异.
To compare therapeutic effects between the normal rehabilitation and combined with manipulative method after arthroscopic capsular release for the treatment of severe frozen shoulder, and to evaluate the application value of manipulationp. Methods：From March 2007 to July 2010, arthroscopic capsular release was performed in 48 cases （48 shoulders, 23 left side, 25 right side）. All the patients were divided into two groups：control group （11 males and 15 females） and manipulation group （9 males and 13 females）. The patients in the control group were treated with conventional rehabilitation procedure, and the patients in the manipulation group were treated with additional manipulation procedure. From the 2nd day after operation,the manipulation was performed for 20 minutes every time,twice daily,and it continued for 10 days. All the cases were followed up and the scale of American Shoulder and Elbow Surgeons Standardized Assessment Form（ASES self-report section） and the range of motion （ROM） were recorded. Results： The mean follow-up period was （12.54±5.78） months （ranging from 4 to 25 months）. Both ASES scores and ROM in the manipulation group were better than those in the control group at the 1 st month after operation, and the difference between the ASES scores and flexion of the shoulder were significant. However, there was no significan difference at the latest follow-up. Conclusion：Compared with the conventional rehabilitative procedure, manipulation following arthroseopic capsular release could promote the process of joint rehabilitation and help the patient back to normal life earlier, but there is no evidence of long term advantage.
出处
《中国骨伤》
CAS
2014年第4期299-302,共4页
China Journal of Orthopaedics and Traumatology
基金
上海市中医临床优势专科项目--骨伤科(编号:ZYSNXD-YL-YSZK-016)~~
关键词
肩凝症
肌肉骨骼手法
关节镜
病例对照研究
Frozen shoulder
Museuloskeletal manipulations
Arthroseopy
Case-control studies
