超声引导下穿刺注射治疗肩峰下滑囊炎的疗效观察

目的评价经超声引导下肩关节穿刺注射治疗肩峰下滑囊炎的临床疗效.方法肩峰下滑囊炎患者60例,按随机数表法分为超声引导组、盲穿注射组和对照组,每组各20例.超声引导组在超声引导下行肩关节穿刺,滑囊内注射复方倍他米松及盐酸利多卡因注射液,1次/周.盲穿注射组经验性选择穿刺点注射同剂量复方倍他米松及盐酸利多卡因注射液,1次/周.对照组予塞来昔布胶囊口服,200mg/次,1次/d,共用药4周.三组患者均予TDP局部照射,1次/d,15min/次.共治疗及随访4周,比较三组治疗前、治疗4周后Constant-Murley评分、肩关节ASES评分.结果治疗前三组患者Constant-Murley评分、ASES评分差异均无统计学意义.治疗4周后,三组患者Constant-Murley评分、ASES评分均提高,差异有统计学意义(P<0.05),超声引导组、盲穿注射组Constant-Murley评分、ASES评分高于对照组,超声引导组Constant-Murley评分、ASES评分高于盲穿注射组,差异有统计学意义(P<0.05).结论穿刺注射治疗肩峰下滑囊炎疗效优于口服药物治疗,能够有效缓解疼痛,改善患者肩关节功能,提高患者的日常生活质量.超声引导下穿刺注射具有精确性,疗效优于经验性穿刺注射,在无明显手术指征下可作为治疗肩峰下滑囊炎的可靠方法.

Objective To observe and evaluate the efficacy of ultrasound-guided shoulder puncture injection in the treatment of subacromial bursitis.Methods Sixty patients with subacromial bursitis who met the test criteria were randomly assigned to the ultrasound-guided group,the blind-injection group and the control group according to the random number table method,with 20 cases in each group.Observation method:Ultrasound-guided group underwent ultrasound-guided shoulder joint puncture,and inside the bursal injection of compound betamethasone and lidocaine hydrochloride injection once a week.The blind-injection group was selected with the same dose of compound betamethasone and lidocaine hydrochloride injection once a week.The control group was given celecoxib capsules once a day,200 mg each time,medication cycle 4 weeks.All three groups were given TDP local irradiation once a day for 15 minutes each time.After treatment and follow-up for 4 weeks,the Constant-Murley score and the ASES score of the shoulder joint were evaluated before treatment,after 4 weeks,and among the three groups.Results There were no significant differences in the Constant-Murley score and ASES score among the three groups before treatment.After 4 weeks of treatment,the Constant-Murley score and ASES score were improved in the three groups.The comparison between the three groups was statistically significant.The Constant-Murley score and the ASES score were higher in the two injection groups than in the control group.The Constant-Murley score and the ASES score in the ultrasound-guided group were higher than those in the blind-injection group.The Constant-Murley score and the ASES score were compared among the three groups,the difference was statistically significant.Conclusion Puncture and injection for the treatment of subacromial bursitis is better than oral medication,which can effectively relieve symptoms,improve shoulder flmction and improve the quality of daily life of patients.Ultrasound-guided puncture injection is more accurate,the effect is better than the empirical puncture injection,and can be used as a reliable method for the treatment of subacromial bursitis without obvious surgical indications.