铍针联合闭合手法松解术治疗僵硬期冻结肩的疗效评价

Clinical Efficacy of Stiletto Needle Combined with Closed Manipulative Release for Adhesive Capsulitis

目的:评价全身麻醉下铍针联合闭合手法松解术治疗僵硬期冻结肩的临床疗效。方法:通过前瞻性研究纳入本院2018年1月至2019年1月,接受静脉全身麻醉下铍针联合闭合手法松解术治疗的僵硬期冻结肩患者,采集术前、术后3d、2周、1个月的评估结果,包括肩部视觉模拟评分(VAS评分)、调整肩关节Constant-Murley评分、患者术后满意度(Odom\s评分),并记录患者的手术时间。结果:最终纳入符合纳入标准的患者共55例,男16例,女39例;年龄44~70岁,平均(57.73±6.94)岁;手术时间为10~34min,平均(20.83±5.29)min。临床疗效:术前至术后3个月,患肩VAS评分逐渐降低,各时间点比较,差异有统计学意义(P<0.01)。肩关节前屈、外展、外旋、内旋在术后均有明显好转,差异有统计学意义(P<0.01),前屈、外展、外旋术后3d即恢复满意,内旋术后3d至术后1个月逐渐恢复。Odom\s评分中末次随访时非常好、好的比例分别为92.7%和7.3%。结论:在术后1个月的随访中,有超过92.7%的铍针联合闭合手法松解术后患者表示非常满意和满意,证明铍针联合闭合手法松解术值得临床进一步推广应用。

Objective:To explore the clinical efficacy of stiletto needle combined with closed manipulative release for adhesive capsulitis.Methods:Inpatients diagnosed with adhesive capsulitis who underwent stiletto needle combined with closed manipulative release were prospectively studied from January 2018 to January 2019.Clinical outcomes were assessed by visual analogue scale(VAS score)adjusted Constant-Murley score and Odom’s criteria at pre-operation and 2 d,2 weeks,1 month post-operation.Results:55 inpatients were enrolled,male-female ratio was 16/39 with age of(57.73±6.94)y,and the surgery time was(20.83±5.29)min.In this study,VAS score was gradual decreasing from pre-operation to 1 month post-operation(P<0.01).The mobility of the shoulder in all directions including forward flexion,abduction,external rotation and internal rotation were significantly improved after surgery.The excellent and good rates based on Odom’s criteria were 92.7%and 7.3%.Conclusion:Stiletto needle combined with closed manipulative release provides a favorable clinical outcome at an average of 1 month follow-up.The excellent and good rate based on Odom’s criteria was92.7%,which is worthy of clinical promotion.