全麻下单纯肩关节松解与复合术后帕瑞昔布钠治疗肩周炎疗效对比

COMPARISON OF THE EFFECT OF SCAPULOHUMERAL ARTICULATION ADHESIOLYSIS WITH THE COMBINED PROCEDURE FOLLOWED BY PARECOXIB SODIUM INJECTION FOR THE TREATMENT OF SCAPULOHUMORAL PERIARTHRITIS

目的:对比全麻下单纯肩关节松解与复合术后帕瑞昔布钠(特耐)治疗肩周炎的疗效。方法:肩周炎病例53例随机分为A组(n=24)和B组(n=29),A组采取丙泊酚静脉麻醉下肩关节松解术,B组采取丙泊酚静脉麻醉下肩关节松解复合术后特耐静滴。对患者术前,术后1、2、3天疼痛进行VAS评分,观察术前、术后肩关节活动情况,随访1个月。结果:术中肌松效果满意53例(100%),B组患者术后疼痛较A组明显下降,B组患者活动度较A组显著改善,B组近期疗效为痊愈者26例(90%),有效者3例(10%),A组近期疗效痊愈者17例(71%),有效4例(17%),无效3例(12%)。无明显不良反应。结论:全麻下肩关节松解复合术后特耐治疗肩周炎较单纯肩关节松解术镇痛效果好,早期肩关节活动度改善显著。

Objective： To compare the effects of scapulohumeral articulation adhesiolysis with the combined procedure of adhesiolysis followed by parecoxib sodium injection.Methods： 53 patients with scapulohumeral periarthritis were enrolled in the study.They were divided into group A（n = 24） and group B（n = 29）.Patients in group A were treated with manual release of adhesion under intravenous propofol,and group B adopted the same procedure followed by the injection of parecoxib sodium.All patients were assessed with VAS scale before and 1,2,3 d after treatment.The joint motion was assessed before the treatment,immediately after and one month after the treatment.Results： The satisfactory rate of intraoperative muscle relaxation was 100%.There was significant pain relief and improvement of joint motion in group B compared with group A.The short term responses with group B was as follows： 26 patients（90%） cured,3 patients（10%） improved;and group A was 17 patients（71%） cured,4 patients（17%） improved and 3 patients（12%） ineffective.No significant side effect was observed.Conclusion： The therapeutic effect and the joint motion improvement with manual release of adhesion under intravenous anesthesia can be improved by paracoxib injection following the surgery.