摘要
目的探讨超声在冻结肩(frozen shoulder,FS)关节囊液压扩张治疗近期疗效预测中的价值。方法选取单侧FS患者100例,采用高频超声评估患肩喙肱韧带(coraco-humeral ligament,CHL)、腋囊厚度等,用组内相关系数(intraclass correlation coefficient,ICC)分析同一医生评估的重复性及不同医生评估的一致性。在超声引导下行患肩液压扩张治疗,记录治疗前和治疗后6周被动活动度(passive range of motion,PROM)、疼痛视觉模拟评分法(visual analogue scale,VAS)、肩关节功能Constant-Murley评分(Constant and Murley score,CMS)。以治疗后CMS改善值是否达到15分为标准将患者分为有效组(≥15分)和无效组(<15分),采用ROC曲线评价超声指标对其疗效的预测价值。采用多元线性回归分析超声检查等指标与治疗后PROM、VAS、CMS改善值的相关性。结果与治疗前比较,治疗后VAS降低,PROM及CMS升高(P均<0.001)。ICC结果显示所有超声评估的可重复性及一致性均非常好,有效组CHL、腋囊厚度<无效组(P均<0.01);有效组PROM、VAS、CMS改善值>无效组(P均<0.01)。ROC曲线分析显示,CHL及腋囊厚度联合预测的的AUC(0.872)高于二者单独预测的AUC(0.801、0.748),差异均有统计学意义(P<0.05),联合预测的敏感度、特异性、准确度分别为85.71%、81.25%、84.00%。回归分析显示,CHL厚度与外旋PROM改善值呈负相关,CHL及腋囊厚度与CMS改善值呈负相关(P均<0.01)。结论超声对FS关节囊液压扩张治疗的近期疗效具有一定预测价值,其中CHL厚度有助于预测PROM、CMS的改善,腋囊厚度有助于预测CMS的改善。
Objective To explore the value of ultrasound in predicting the short-term efficacy of glenohumeral joint hydrodilatation in the Treatment of frozen shoulder.Methods A total of 100 patients with unilateral frozen shoulder were enrolled,high-frequency ultrasound evaluation of the coraco-humeral ligament(CHL),axillary sac thickness and other ultrasound indicators were performed.The intra-group correlation coefficient was used to study the repeatability of the same doctor evaluation and the consistency of different doctor evaluation.Ultrasound-guided the glenohumeral joint was hydrodilatation therapy.The patient′s glenohumeral passive range of motion(PROM),pain visual analogue scale(VAS)score,glenohumeral joint function Constant-Murley score(CMS)were recorded before and 6 weeks after treatment.The patients were divided into effective group(≥15 points)and ineffective group(<15 points)according to whether the CMS improvement value reached 15 points after treatment,and ROC curve was used to evaluate the effects of ultrasound indicators on their efficacy forecast value.The correlation between the ultrasonic examination and other indicators and the improvement values of PROM,VAS,CMS after treatment was analyzed by multiple linear regression.Results Compared with before treatment,the VAS score decreased after treatment,and the PROM and CMS increased(P<0.001).ICC results showed that the repeatability and consistency of all ultrasound evaluation were very good,CHL thickness and axillary thickness in the effective group were less than those in the ineffective group(P<0.01).The improvement values of PROM,VAS,CMS in the effective group were greater than those in the ineffective group(P<0.01).ROC curve analysis showed that the AUC of CHL and axillary sac thickness to predict the effect of frozen shoulder were 0.801 and 0.748,respectively.The combined prediction AUC(0.872)was significantly higher than the two alone predictions,and the difference was statistically significant(P<0.05).The sensitivity,specificity and accuracy of
作者
漆家高
郭道宁
邹晓攀
范俊
韩小军
苏牟潇
谢刚泰
QI Jiagao;GUO Daoning;ZOU Xiaopan(Department of Ultrasonography,Mianyang Central Hospital,School of Medicine,Universi-ty of Electronic Science and Technology,Sichuan 621000,China)
出处
《医学研究杂志》
2022年第2期92-96,131,共6页
Journal of Medical Research
基金
四川省卫生健康委员会普及应用项目(19PJ111)
四川省绵阳市卫生健康委员会科研项目(201919)。
关键词
超声检查
冻结肩
液压扩张
Ultrasonography
Frozen shoulder
Hydrodilatation
