肌骨超声引导下穿刺减压联合肩峰下注射治疗肩关节钙化性肌腱炎的短期疗效

Short-term outcome of ultrasound-guided needle puncture decompression combined with subacromial injection in the treatment of shoulder calcific tendinitis

目的探讨肌骨超声引导下穿刺减压联合肩峰下注射治疗肩关节钙化性肌腱炎的短期疗效。方法回顾性分析2016年8月至2019年2月采用肌骨超声引导下穿刺减压联合肩峰下滑膜注射治疗的18例肩关节钙化性肌腱炎患者的临床资料,评估治疗前后视觉模拟量表(VAS)评分和肩关节Constant评分变化,记录并发症发生情况,观察随访期间肌腱炎复发及钙化灶消失情况。结果平均操作时间(7.0±2.0)min,平均治疗费用(209.4±8.0)元。治疗过程中未出现副反应,治疗后疼痛立刻缓解,未见复发。治疗前、治疗后1周、末次随访VAS评分和肩关节Constant评分分别为(8.8±0.9)、(1.0±0.8)、(0.6±0.5)分和(24.4±11.6)、(75.6±6.5)、(88.5±2.8)分,治疗前后比较,差异有统计学意义(P<0.05)。随访时间3~13个月,平均随访时间(6.1±3.0)个月。随访期间未有肩关节无力、肩袖损伤、神经损伤并发症发生,未见钙化性肌腱炎复发,超过6个月复查的18例患者的X线片钙化灶消失时间(7.4±1.4)个月。结论肌骨超声引导下穿刺减压联合肩峰下注射治疗肩关节钙化性肌腱炎具有操作简单、起效快、定位精准、成本低,疗效持久的优势,短期疗效满意,值得在基层医院及门诊部推广。

Objective To investigate the short-term efficacy of ultrasound-guided needle puncture decompression and subacromial injection in the treatment of shoulder calcific tendinitis.Methods Clinical data of 18 patients treated by ultrasound-guided needle puncture decompression and subarcomial injection from August 2016 to Feburary 2019 were retrospectively analyzed.Visual analogue scale(VAS)score and shoulder Constant score before and after treatment were evaluated,the complications were recorded,reocurrence of calcific tendinitis and disappearance of calcification during the period of follow-up were also observed.Results The average procedure time was(7.0±2.0)min,the average cost of treatment was(209.4±8.0)RMB.There were no side effects during the treatment,and immediate pain relief was obtained without reoccurrence.VAS score and shoulder Constant score before treatment,1 week after treatment and at the lastest follow-up was(8.8±0.9),(1.0±0.8),(0.6±0.5)and(24.4±11.6),(75.6±6.5),(88.5±2.8)respectively.The results showed no statistical differences between pre-treatment and post-treatment(P<0.05).The average follow-up time was(6.1±3.0)months(3 to 13 months).During the period of the follow-up,no complications such as shoulder weakness,rotator cuff or nerve injuries were found,and no reoccurrence of calcific tendinitis had happened in all patients.For 18 patients who had a follow-up more than 6 months,the time when X-ray showed the disappearance of calcification was(7.4±1.4)months.Conclusion Ultrasound-guided needle puncture decompression combined with subacromial injection in the treatment of shoulder calcific tendinitis has advantages of simple procedure,rapid onset of effect,precise positioning,low cost and long-lasting curative effect with satisfactory short-term efficacy,which is worthy of being popularized in regional hospitals and the clinics.