手法松解与关节镜下松解关节囊对冻结肩患者术后关节活动度的影响

Effect of manipulation release and arthroscopic capsular release on postoperative joint range of motion in patients with frozen shoulder

目的:探讨手法松解与关节镜下松解关节囊对冻结肩患者术后活动度的影响。方法:选择某院确诊的冻结肩患者62例,按照治疗方法的不同分为对照组和观察组,每组31例。对照组采用手法松解治疗,观察组采用关节镜下松解关节囊治疗,比较2组患者治疗后前屈、外展、外旋、内旋的关节活动度评分、视觉疼痛评分(VAS)、美国肩肘外科协会(ASES)评分和生活质量评分。结果:治疗3个月后,观察组前屈、外旋、内旋、外展肩关节功能评分均优于对照组,2组比较差异有统计学意义(P<0.05);治疗后2组患者外旋、内旋、前屈的肌肉力量均较治疗前增加,且观察组高于对照组,2组比较差异有统计学意义(P<0.05);治疗后2组患者VAS评分降低,ASES评分升高,观察组ASES评分高于对照组,2组比较差异有统计学意义(P<0.05);治疗后观察组患者心理健康、情感角色、躯体功能、社会功能、健康状态、生活力、肌体疼痛、躯体角色生活质量评分高于对照组,差异有统计学意(P<0.05)。结论:与手法松解比较,关节镜下松解关节囊治疗冻结肩可增加关节活动度,提升肌肉力量,促进肩关节功能的恢复,提高患者生活质量。

Objective:To explore the effect of manipulation release and arthroscopic capsular release on postoperative anteflexion and extorsion of patients with frozen shoulder.Methods:62 patients with frozen shoulder diagnosed in a hospital were selected and divided into a control group and an observation group according to different treatment methods,with 31 cases in each group.The control group underwent manipulation release and the observation group adopted arthroscopic capsular release.The two groups were compared before and after the treatment in terms of the ranges of anteflexion,abduction,extorsion and internal rotation,as well as the visual analogue scale(VAS)scores,the American Shoulder and Elbow Surgeons(ASES)scores,and quality of life scores.Results:3 months after the treatment,the shoulder function scores of anteflexion,extorsion,internal rotation and abduction in the observation group were significantly better than those in the control group(P<0.05).The muscle strength of extorsion,internal rotation and anteflexion in both groups were significantly increased after the treatment and significantly higher in the observation group than in the control group(P<0.05).After the treatment,the VAS scores were significantly decreased,and the ASES scores were significantly increased in both groups,with the ASES scores of the observation group being significantly higher than those of the control group(P<0.05).After the treatment,scores of mental health,emotional role,physical function,social function,health status,vitality,body pain and physical role of the observation group were significantly higher than those of the control group(P<0.05).Conclusion:Compared with manipulation release,arthroscopic capsular release can improve the joint mobility and muscle strength,promote the recovery of shoulder function and ameliorate the patient's quality of life.