手法松解术治疗慢性肩袖损伤的临床观察

Clinical Observation of Closed Manipulative Release in the Treatment of Chronic Rotator Cuff Injury

目的:探讨手法松解术治疗慢性肩袖损伤的临床疗效及安全性。方法:选取2018年6月至2019年6月收治的慢性肩袖损伤患者48例,随机分为观察组(n=24)与对照组(n=24),观察组采用超声引导臂丛阻滞麻醉下手法松解术治疗,对照组行超声引导下肩峰下滑囊注射术治疗。分别采用疼痛视觉模拟评分(VAS)、肩关节活动度及美国加州大学肩关节评分(UCLA)评定两组患者的临床疗效。记录不良反应及并发症,评价其安全性。结果:观察组全部完成随访,对照组有2例未完成随访,最终观察组24例(n=24),对照组22例(n=22)。两组患者治疗后肩关节各项指标都有所好转。观察组治疗后肩关节活动度、UCLA均优于对照组,差异有统计学意义(P<0.05)。观察组治疗后1周VAS评分劣于对照组,差异有统计学意义(P<0.05),治疗后1个月VAS评分与对照组差异无统计学意义(P>0.05),治疗后3个月VAS评分优于对照组,差异有统计学意义(P<0.05)。治疗后均未见并发症的发生。结论:手法松解术治疗慢性肩袖损伤安全有效,能更好地改善患者肩关节功能并且缓解疼痛,值得临床推广应用。

Objective:To explore the clinical efficacy and safety of closed manipulative release in the treatment of chronic rotator cuff injury.Methods:48patients with chronic rotator cuff injury were selected from June 2018to June 2019,Who were randomly divided into observation group(n=24)and control group(n=24).The observation group was treated with ultrasound-guided brachial plexus block anesthesia under manipulative release,the control group was treated with ultrasound-guided subacromial humeral capsule injection.Visual analogue scale(VAS)of pain,shoulder joint range of motion and University of California shoulder joint score(UCLA)were used to evaluate the clinical efficacy of the two groups.Adverse reactions and complications were observed and recorded to evaluate their safety.Results:All patients in the observation group were followed up,while 2patients in the control group were not followed up,and there were 24patients in the final observation group(n=24)and 22patients in the control group(n=22).After treatment,all indicators of shoulder joint improved in both groups.The range of motion and UCLA of shoulder joint in the observation group were better than those in the control group,and the difference was statistically significant(P<0.05).VAS score of the observation group was worse than that of the control group at one week after treatment,with statistically significant difference(P<0.05),no statistically significant difference between VAS score at one month and that of the control group(P>0.05),and VAS score at 3months was better than that of the control group,with statistically significant difference(P<0.05).No complications were found in two groups.Conclusion:Closed manipulative release is safety and efficacy in the treatment of chronic rotator cuff injury,can better improve the function of the shoulder joint and relieve pain,and is worthy of clinical application.