颈丛麻醉下手法加静脉镇痛治疗冻结肩的机理研究

Mechanism study on manipulation and intravenous analgesia under block anesthesia of cervical plexus in the treatment of frozen shoulder

目的观察颈丛麻下手法加静脉镇痛治疗冻结肩的临床疗效,通过观察造影前后肩关节腔内的显影变化,分析其作用机理。方法对60例冻结肩患者在颈丛麻下行手法松解,松解前行肩关节腔造影,观察松解前后关节腔造影剂的显影变化。结果随访半年后治疗愈合率18.33%,优良率78.33%;造影显示,松解前关节腔容积明显变小,平均约7mL关节囊粘连挛缩,松解后造影剂向关节囊外各方向扩散。结论颈丛麻下手法加静脉镇痛治疗冻结肩疗效显著,麻醉下运用手法能撕裂松解粘连的关节囊。

Objective To observe the clinical efficacy of manipulation and intravenous analgesia under block anesthesia of cervical plexus in the treatment of frozen shoulder,and analyze its mechanism by observing the developer changes of shoulder joint cavity before and after arthrography. Methods Sixty cases of frozen shoulder were implemented manipulative release under block anesthesia of cervical plexus,and the shoulder arthrography of patients were done before release,the developer changes of contrast agent in shoulder joint cavity were observed before and after release. Results After six months of following-up,the healing rate was 18.33%,the excellent rate was 78.33%;The angiography showed that the joint cavity volume got significantly smaller before release, averaging about 7mL joint capsule got adhesion and contracture,contrast agent spread to all directions outside the joint capsule after release. Conclusion Manipulation and intravenous analgesia under block anesthesia of cervical plexus in the treatment of frozen shoulder has significant efficacy,manipulation under block anesthesia of cervical plexus can tear and relieve the adhesion joint capsule.