微创手术与药物治疗对早期原发性冻结肩患者近期和远期效果的比较

发布时间：2019-03-03 14:58

【摘要】：目的比较微创手术与药物治疗对早期原发性冻结肩(PFS)患者的近期和远期效果。方法选取2014年6月-2015年9月该科收治入院的82例PFS患者为研究对象,随机分为药物组与手术组两组,各41例。对照组患者行关节腔内固醇激素注射治疗,观察组患者行关节镜下盂肱关节与肩峰下间隙的清理松解术。比较两组的基线资料、治疗前后的视觉模拟评分(VAS)、Constant肩关节评分、内旋、外旋、外展、前屈的主动关节活动度(ROM)。结果两组的基线资料、治疗前的VAS评分、Constant肩关节评分、主动ROM比较,差异无统计学意义(P0.05),具有可比性。与治疗前相比,两组患者治疗后的VAS评分均明显降低,Constant肩关节评分、主动ROM均明显升高,差异有统计学意义(P0.05)。在治疗后4周,手术组患者的VAS评分明显高于药物组,Constant肩关节评分、主动ROM明显低于药物组,差异有统计学意义(P0.05)。在治疗后12周、半年和1年,手术组患者的VAS评分明显低于药物组,Constant肩关节评分、主动ROM明显高于药物组,差异有统计学意义(P0.05)。结论肩关节镜下微创手术与药物注射都是早期PFS患者的有效治疗方法,药物注射的近期疗效显著,但远期疗效较差,而微创手术的远期效果更加突出,配合术后的药物口服和康复锻炼能显著改善其肩关节功能和生活质量,值得临床推广应用。
[Abstract]:Objective to compare the short-term and long-term effects of minimally invasive surgery and drug therapy on early primary frozen shoulder (PFS) patients. Methods 82 patients with PFS admitted to the department from June 2014 to September 2015 were randomly divided into two groups: drug group (n = 41) and operation group (n = 41). The patients in the control group received intraarticular corticosteroids injection and the patients in the observation group underwent arthroscopic clearance of the space between the glenohumeral joint and the subacromial space. Baseline data of the two groups were compared. Visual analogue score (VAS), Constant), shoulder joint score, internal rotation, abduction and anterior flexion of the active joint were evaluated before and after treatment. The active range of motion of the joint was (ROM). Results there was no significant difference between the two groups in baseline data, VAS score before treatment, Constant shoulder joint score and active ROM (P0.05). Compared with the pre-treatment, the VAS scores of the two groups were significantly lower, the Constant shoulder joint score and active ROM were significantly higher than those before treatment, the difference was statistically significant (P0.05). 4 weeks after treatment, the VAS score in the operation group was significantly higher than that in the drug group, and the Constant shoulder joint score and active ROM in the operation group were significantly lower than those in the drug group (P0.05). At 12 weeks, 6 months and 1 year after treatment, the VAS score in the operation group was significantly lower than that in the drug group, and the Constant shoulder joint score and active ROM in the operation group were significantly higher than those in the drug group (P0.05). Conclusion both minimally invasive surgery under shoulder arthroscopy and drug injection are effective methods for the treatment of early PFS patients. The short-term effect of drug injection is remarkable, but the long-term effect is poor, and the long-term effect of minimally invasive surgery is more prominent. Combined with oral medication and rehabilitation exercise, the shoulder joint function and quality of life can be significantly improved, which is worthy of clinical application.
【作者单位】：山东省临沂市中心医院骨科;
【分类号】：R684

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