局部封闭联合手法松解术与关节镜粘连松解术治疗原发性肩周炎疗效比较

Comparison of partial closure combined manipulation release and arthroscopic adhesion release in treating primary shoulder periarthritis

目的 探讨局部封闭联合手法松解术与关节镜粘连松解术治疗原发性肩周炎的疗效。方法 选取2011年1月至2015年1月成都大学附属医院收治的原发性肩周炎患者435例（490侧）,其中双侧肩周炎55例。行局部封闭联合手法松解术治疗408例（463侧）作为手法松解组,肩关节镜粘连松解术治疗27例（27侧）作为关节镜松解组;比较两组患者术后并发症发生情况,用美国肩肘外科评分（ASES）及肩关节疾患治疗成绩判定标准（JOA）评分和肩关节活动度对两组患者进行疗效比较。两组患者均获门诊或电话随访,手法松解组随访时间3-16个月,平均（7.2±1.1）个月;关节镜松解组随访时间6-24个月,平均（11.3±1.6）个月。结果 两组患者治疗后均具有明显效果,手法松解组患者术后ASES、JOA评分均明显高于关节镜松解组,差异均有统计学意义（P〈0.05）。结论 局部封闭联合手法松解术治疗原发性肩周炎疗效明显,且优于关节镜粘连松解术,由于其创伤小、治疗时间短、效果好而受到患者青睐。

Objective To explore the curative effect of partial closure combined manipulation release and arthroscopic adhesion release in treating primary shoulder periarthritis. Methods A total of 435 cases（490 sides） of primary shoulder periarthritis in the Affiliated Hospital of Chengdu University from January 2011 to January 2015 were selected ,including 55 cases of bilateral shoulder periarthritis. Among them,408 cases（463 sides） as the manipulation release group were treated with partial closure com-bined with manipulation release and 27 cases（27 sides）as the arthroscopic release group were treated by shoulder arthroscopic adhesions release. The occurrence situation of postoperative complications was compared between the two groups. The curative ef-fects were compared between the two groups by using the ASES and JOA scores and shoulder range of motion. The patients in the two groups all obtained the outpatient or telephone follow up. the manipulation release group was followed up for 3-16 months , average（7.2±1.1） months;the arthroscopic release group was followed up for 6-24 months,average（11.3±1.6） months. Results The two groups all had obvious effect after therapy. The postoperative ASES and JOA scores in the manipulation release group were significantly higher than those in the arthroscopic release group,the difference was statistically significant（P〈0.05）. Conclu-sion Partial closure combined with manipulation release has obvious effect in treating primary shoulder periarthritis ,which is supe-rior to the arthroscopic adhesion release and is well received by the patients due to small trauma,short treatment time and good effect.