超声引导下玻璃酸钠关节腔内注射对肩周炎患者炎症反应及疼痛症状的影响

Effect of Intra-Articular Injection of Sodium Hyaluronate Under Ultrasound Guidance on Inflammatory Response and Pain Symptoms in Patients with Scapulohumeral Periarthritis

目的探讨超声引导下玻璃酸钠关节腔内注射对肩周炎患者炎症反应及疼痛症状的影响。方法选取我院2020年1月—2022年1月收治的80例肩周炎患者为研究对象,按随机数字表法将其分为对照组与观察组,每组40例。对照组采用传统肩周痛点注药治疗,观察组采取传统肩周痛点联合超声引导下玻璃酸钠关节腔内注射治疗,两组均用药4周。对比两组患者的临床疗效、肩关节活动度、炎症反应水平及疼痛症状。结果观察组的治疗总有效率为92.50%,高于对照组的75.00%,差异有统计学意义(P<0.05)。治疗前,两组肩关节活动度比较,差异无统计学意义(P>0.05)。治疗后,观察组的前屈活动度为(146.18±7.95)°,外展为(92.41±6.52)°,外旋为(39.42±5.97)°,均大于对照组的(124.65±5.81)°、(68.76±5.14)°、(27.94±4.32)°,组间差异有统计学意义(P<0.05)。治疗前,两组炎症反应水平比较,差异无统计学意义(P>0.05)。治疗后,观察组的环氧合酶为(27.39±2.41)pg/mL,肿瘤坏死因子-α为(12.34±2.19)pg/mL,均低于对照组的(33.64±3.26)pg/mL、(16.75±3.28)pg/mL,组间差异有统计学意义(P<0.05)。治疗前,两组疼痛视觉模拟(VAS)评分比较,差异无统计学意义(P>0.05),治疗后,观察组的VAS评分为(1.45±0.68)分,低于对照组的(2.72±1.14)分,差异有统计学意义(P<0.05)。结论对肩周炎患者加用超声引导下玻璃酸钠关节腔内注射治疗可显著提高临床疗效,改善患者肩关节活动度,降低炎症反应水平,缓解患者疼痛症状。

Objective To investigate the effect of ultrasound guided intra-articular injection of sodium hyaluronate on inflammatory response and pain symptoms in patients with scapulohumeral periarthritis.Methods 80 patients with periarthritis of shoulder treated in our hospital from January 2020 to January 2022 were selected as the study objects,and were divided into a control group and an observation group according to random number table method,with 40 cases in each group.The control group was treated with traditional injection of pain points around the shoulder,and the observation group was treated with traditional injection of pain points around the shoulder combined with ultrasound-guided intraarticular injection of sodium hyaluronate,both groups were treated for 4 weeks.The clinical efficacy,shoulder joint motion,inflammatory response and pain symptoms were compared between the two groups.Results The total effective rate of the observation group was 92.50%,which was higher than 75.00%of the control group,the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in shoulder joint motion between the two groups(P>0.05).After treatment,the anterior flexion of the observation group was(146.18±7.95)°,the extension was(92.41±6.52)°,and the external rotation was(39.42±5.97)°,which were greater than(124.65±5.81)°,(68.76±5.14)°,(27.94±4.32)°of the control group,the differences between groups were statistically significant(P<0.05).Before treatment,there was no significant difference in the level of inflammatory response between the two groups(P>0.05).After treatment,the levels of cyclooxygenase and tumor necrosis factor-α in the observation group were(27.39±2.41)pg/mL and(12.34±2.19)pg/mL,which were lower than(33.64±3.26)pg/mL and(16.75±3.28)pg/mL in the control group,and the differences between groups were statistically significant(P<0.05).Before treatment,there was no significant difference in the pain Visual Analogue Scale(VAS)score between the two groups(P>0.05).After treatment,VAS score of the observation group was(1.45±0.68)points,which was lower than(2.72±1.14)points of the control group,and the difference was statistically significant(P<0.05).Conclusion Adding ultrasound guided intra-articular injection of sodium hyaluronate to patients with shoulder periarthritis can significantly improve clinical efficacy,improve shoulder joint mobility,reduce inflammatory response levels,and alleviate pain symptoms.