摘要
目的探讨超声引导下局部注射糖皮质激素在治疗肩袖钙化性肌腱炎中的临床疗效。方法采用前瞻性研究方法,选取2020年1月至11月首都医科大学附属北京友谊医院收治的单侧肩袖钙化性患者60例,按照随机数字表法将患者分为对照组和超声引导下注射组,每组30例。超声引导下注射组在超声引导下使用穿刺肩袖病灶针减压并将倍他米松注射液2 mL和利多卡因1 mL注射到肩峰下滑囊;对照组患者使用发散式体外冲击波治疗钙化性肌腱炎,每3 d接受1次治疗,共治疗5次。所有患者门诊随访12周,记录治疗前和末次随访时患者的视觉模拟评分法(VAS)评分、牛津肩关节评分问卷评分(OSS)、Constant-Murley肩关节功能评分(CS),比较末次随访时的治疗有效率以及患者对治疗效果满意度。结果所有患者均得到完整随访。治疗前,两组间VAS评分比较,差异均无统计学意义(P>0.05);末次随访时,超声引导下注射组患者VAS评分为(2.3±0.4)分,明显低于对照组[(3.9±0.4)分],差异有统计学意义(P<0.05)。治疗前,两组患者OSS和CS评分比较,差异均无统计学意义(P>0.05);末次随访时,超声引导下注射组患者OSS评分为(21.0±3.9)分,低于对照组[(36.3±4.5)分],CS评分为(77.9±7.6)分,明显高于对照组[(68.0±6.5)分],差异均有统计学意义(P<0.05)。末次随访时,超声引导下注射组患者的治疗有效率为76.7%,明显高于对照组(43.3%),差异有统计学意义(P<0.05);超声引导下注射组患者的治疗满意度为73.3%,明显高于对照组(53.3%),差异有统计学意义(P<0.05)。结论超声引导下局部注射糖皮质激素能够减轻肩袖钙化性肌腱炎引起的疼痛,并且提高肩关节功能,是肩袖钙化性肌腱炎有效的非手术治疗方法。
Objective To investigate the efficacy of ultrasound-guided local corticosteroid injection for treating calcific tendinitis of the rotator cuff.Methods A prospective study was performed from January 2020 to November 2020.In Beijing Friendship Hospital,Capital Medical University,sixty patients who suffered calcific tendinitis of the rotator cuff were enrolled and divided into two groups equally according to the of random number table method:control group and ultrasound-guided injection group,30 cases in each group.The patients in ultrasound-guided injection group were treated by needle puncture decompression at the location of rotator cuff and injection of 2 mL Dexamethasone mixed with 1 mL 1%Lidocaine deep to the subacromial bursa.While the patients in control group were treated by radial extracorporeal shockwave therapy,one extracorporeal shockwave therapy was accepted every 3 days,a total of five times.All the patients were outpatient followed for 12 weeks.Visual analogue scale(VAS),Oxford Shoulder Score(OSS)and Constant-Murley score(CS)before treatment and final followed-up of all patients were recorded and compared.While effective rate and satisfaction rate of three groups were recorded and compared at final followed-up.Results All the patients were followed-up.Before treatment,there was no statistically significant difference in VAS score between the two groups(P>0.05);at the last follow-up,the VAS score of the patients in the ultrasound-guided injection group was(2.3±0.4)points,which was significantly lower than that in the control group[(3.9±0.4)points],and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in OSS and CS scores between the two groups(P>0.05);at the last follow-up,the OSS score of the patients in the ultrasound-guided injection group was(21.0±3.9)points,which was lower than that of the control group[(36.3±4.5)points],and the CS score was(77.9±7.6)points,which was significantly higher than that of the control group[(68.0±6.5)points]
作者
柳曦
钱林学
李智尧
李谷峰
LIU Xi;Qian Lin-xue;LI Zhi-yao(Department of Ultrasound,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Orthopaedics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《临床和实验医学杂志》
2022年第21期2337-2341,共5页
Journal of Clinical and Experimental Medicine
基金
北京市自然科学基金资助项目(编号:7222035)。
关键词
钙化性肌腱炎
超声引导
药物注射
糖皮质激素
功能恢复
Calcific tendinitis
Ultrasound-guided
Drug injection
Corticosteroid
Function recovery
