超声引导下肩胛上神经联合腋神经阻滞治疗粘连性肩关节囊炎的疗效

Ultrasound-guided suprascapular nerve block combined with axillary nerve block for the treatment of patients with frozen shoulder

目的探讨超声引导下肩胛上神经联合腋神经阻滞治疗粘连性肩关节囊炎的临床疗效。方法收集2018年6月至2018年12月于通辽市医院疼痛门诊就诊的粘连性肩关节囊炎患者120例,按照随机数字表法随机分为痛点注射组和神经阻滞组,每组60例。痛点注射组采用痛点注射治疗,神经阻滞组采用肩胛上神经联合腋神经阻滞治疗,两组治疗均为1次/周,共治疗3次。所有患者均辅以功能锻炼。观察患者治疗前及首次治疗后1周、2周、3周、1个月、3个月时的视觉模拟评分(VAS)和肩关节功能评分的变化。结果两组患者在性别、年龄、患病侧别、病程、治疗前VAS评分方面比较差异均无统计学意义(P均>0.05)。两组患者治疗后各时点VAS评分均较治疗前显著降低,肩关节功能评分均较治疗前显著提高(P均<0.05)。神经阻滞组治疗后VAS评分、肩关节功能评分均较痛点注射组有更明显改善(P均<0.05)。两组均未见严重不良反应。结论超声引导下肩胛上神经联合腋神经阻滞治疗粘连性肩关节囊炎可有效减轻患者的疼痛,改善关节活动度,提高生活质量。

Objective To study the effect of ultrasound-guided suprascapular nerve block combined with axillary nerve block in the treatment of patients with frozen shoulder.Methods One hundred and twenty patients with frozen shoulder,treated in Pain Clinic,Tongliao City Hospital from June 2018 to December 2018,were randomly divided into control group and nerve block group,with 60 cases in each group.Patients were treated by tender points injection in control group,while patients were treated by ultrasound-guided suprascapular nerve combined with axillary nerve block in the nerve block group,once a week,three times as a course of the treatment.All patients were assisted with functional exercises.Visual analogue scale(VAS)and shoulder function scores were observed before the treatment and 1 week,2 weeks,3 weeks,1 month and 3 months after the first treatment.Results There was no significant difference in gender,age,diseased side,course of disease and VAS before the treatment between the two groups(all P>0.05).VAS and shoulder function scores were significantly improved at all time points after the treatment in both groups compared with the control group(all P<0.05).VAS and shoulder function scores were significantly improved in nerve block group after the treatment,compared with the control group(all P<0.05),and no serious adverse reactions were found in both groups.Conclusion Ultrasound-guided suprascapular nerve block combined with axillary nerve block can effectively alleviate pain,improve joint mobility and quality of life in the treatment of frozen shoulder.