臂丛麻醉下肩关节松解术联合玻璃酸钠关节腔内注射治疗冻结期肩周炎疗效研究

Research on Curative Effect of Shoulder Joint Release under Brachial Plexus Anesthesia Combined with Intracavitary Injection of Sodium Hyaluronate Joint in Treatment of Periarthritis of Shoulder

目的观察臂丛麻醉下肩关节松解术联合玻璃酸钠关节腔内注射治疗冻结期肩周炎的临床疗效。方法方便选取2016年3月—2017年9月于该院治疗前肩周炎患者64例,分为对照组和治疗组,每组32例。对照组采用臂丛麻醉下肩关节松解术,治疗组在此基础上加载玻璃酸钠关节腔内注射,分别于治疗前及治疗后7、30、90 d后,比较视觉模拟评分(Visual Analogue Scale,VAS)和牛津大学肩关节功能评分(Oxford Shoulder Score,OSS),并评价两组患者综合临床疗效。结果治疗组和对照组治疗后7 d VAS评分分别为(3.50±0.34)分、(5.59±0.32)分,差异有统计学意义(t=-9.17,P<0.05);治疗组和对照组治疗后90 d肩关节OSS评分分别为(46.47±8.14)分、(42.53±7.31)分,差异有统计学意义(t=2.03,P<0.05);治疗组疗效(75.00%)明显好于对照组(53.13%),差异有统计学意义(Z=-2.19,P<0.05)。结论臂丛麻醉下肩关节松解术联合玻璃酸钠关节腔内注射疗效确切,不良反应少,值得临床推广应用。

Objective To observe the clinical curative effect of shoulder joint release under brachial plexus anesthesia combined with intracavitary injection of sodium hyaluronate joint in treatment of periarthritis of shoulder. Methods 64 cases of periarthritis of shoulder patients in our hospital from March 2016 to September 2017 were convenient selected and divided into two groups with 32 cases in each, the control group and the treatment group were respectively treated with shoulder joint release under brachial plexus anesthesia combined with intracavitary injection of sodium hyaluronate joint, and the VAS and OSS were compared after 7, 30 and 90 days, and the general clinical curative effect of the two groups was evaluated. Results The VAS scores in 7 d after treatment in the treatment group and in the control group were respectively（3.50±0.34）points,（5.59±0.32）points, and the difference was statistically significant（t=9.17, P〈0.05）; and the OSS scores of shoulder joint in 90 days after treatment in the treatment group and in the control group were respectively（46.47 ±8.14）points,（42.53±7.31）points, and the differences were statistically significant（t=2.03, P〈0.05）; and the curative effect in the treatment group was obviously better than that in the control group（75.00% vs 53.13%）, and the difference was statistically significant（Z=-2.19, P〈0.05）. Conclusion The curative effect of shoulder joint release under brachial plexus anesthesia combined with intracavitary injection of sodium hyaluronate joint is definite, with few adverse reactions, and it is worth clinical promotion and application.