超声引导下复方倍他米松联合玻璃酸钠注射治疗肩峰下滑囊炎的临床研究

Effectiveness of ultrasound-guided subacromial bursa injection of betamethasone combined with hyaluronate in treatment of subacromial bursitis

目的评价超声引导下复方倍他米松联合玻璃酸钠注射治疗肩峰下滑囊炎(SAB)的疗效。方法收集2013年1月至2014年9月因肩部疼痛于四川省人民医院附属医院超声科就诊的门诊患者200例,将其中72例诊断为单纯性SAB且欲行超声引导下肩峰下滑囊注射治疗的患者纳入本研究,随机分为2组。试验组给予复方倍他米松联合玻璃酸钠注射,对照组给予复方倍他米松注射,所有患者治疗后第1周和第4周进行电话随访,治疗前、后均进行疼痛评分(视觉模拟评分法,VAS)和肩关节主动外展活动度评分。结果 2组患者治疗后1周和4周,VAS评分及肩关节主动外展活动度评分均较治疗前明显改善(P均<0.05)。治疗后1周,试验组与对照组VAS评分及肩关节主动外展活动度评分比较,差异无统计学意义(P均>0.05);治疗后4周,试验组VAS评分明显低于对照组(2.08±1.95 vs 3.14±2.0,P<0.05),试验组肩关节主动外展活动度评分明显高于对照组(7.12±2.10 vs 6.11±1.93,P<0.05)。结论超声引导下肩峰下滑囊内复方倍他米松联合玻璃酸钠注射可有效治疗SAB,其缓解疼痛及改善肩关节主动外展活动范围的短期疗效优于单一使用复方倍他米松注射治疗。

Objective To evaluate the effectiveness of ultrasound-graded （US-guided） subacromial bursa injection of betamethasone combined with hyaluronate for treatment of subacromial bursitis. Methods A total of 72 patients who were diagnosed as subacromial bursitis by ultrasound and then decided to performed US-guided subacromial bursa injection were randomly divided into two groups. The study group was treated with compound betamethasone suspension followed by sodium hyaluronate, and the control group was treated only with compound betamethasone suspension. Visual analogue score （VAS） and the shoulder active abduction range of motion （AAROM） score were observed before treatment, 1 week and 4 weeks post-treatment during 1 month＇s followed-up. Results There were significantly decreased in VAS score and increased in AAROM score at 1 week and 4 weeks post treatment for both groups （both P 〈 0.05）. There was no difference of both VAS score and AAROM score between the two groups at 1 week post treatment （both P 〉 0.05）. But at 4 weeks post treatment, the VAS score of the study group was significantly lower than that of the control group （2.08＋ 1.95 vs 3.14＋2.0, P 〈 0.05）, while the AAROM score of the study group was significantly higher than that of the control group （7.12＋ 2.10 vs 6.11 ＋ 1.93, P 〈 0.05）. Conclusions Ultrasotmd-guided subacromial bursa injection of betamethasone combined with hyaluronate is effective in treating subacromial bursitis. It produces better pain and active abduction functional improvement than betamethasone at a short-term follow-up.