生物多糖胶液预防冻结肩关节镜松解术后再粘连的疗效观察

Assessment of the effect of biological polysaccharide colloidal solution to prevent re-adhesion after arthroscopic lysis of frozen shoulder

目的探讨生物多糖胶液冲洗对冻结肩关节镜松解术后患者疼痛及康复的影响。方法自2016年3月~2018年11月,对68例冻结肩患者随机分为观察组和对照组,每组34例,两组患者均行关节镜松解手术。观察组:在关节镜松解后用生物多糖胶液冲洗关节腔;对照组仅行关节镜松解手术,未注入药物。平均随访7.3个月,分别观察患者术前、术后6个月时疼痛视觉模拟量表(VAS)评分、美国肩肘外科协会(ASES)肩关节功能评分和美国加州大学洛杉矶分校(UCLA)肩关节评分,评价手术疗效,并将观察组和对照组数据对比,评价药物影响。结果全部病例均获随访,通过术前、术后6个月临床数据对比研究发现,观察组VAS评分由术前(8.1±0.5)分下降至(0.9±0.4)分(t=65.564,P<0.05),对照组由术前(8.3±0.4)分下降至(1.0±0.2)分(t=95.183,P<0.05)。观察组ASES评分由术前(55.4±4.5)分改善为(93.3±2.6)分(t=42.522,P<0.05),对照组ASES评分由术前(57.1±4.2)分改善为(82.5±3.1)分(t=28.372,P<0.05)。观察组UCLA评分由术前(13.5±2.2)分改善为(30.3±1.6)分(t=36.012,P<0.05),对照组UCLA评分由术前(12.9±2.4)分改善为(27.4±2.1)分(t=26.514,P<0.05),两组数据术前、术后比较差异有统计学意义。术后6个月,两组VAS评分比较差异无统计学意义(t=-1.304,P>0.05);观察组ASES评分优于对照组,差异有统计学意义(t=15.565,P<0.05);观察组UCLA评分优于对照组,差异有统计学意义(t=6.405,P<0.05)。结论生物多糖胶液冲洗的应用与常规关节镜松解手术相比,能有效提高术后的肩关节功能,防止关节再粘连,值得临床推广应用。

Objective To investigate the effect of joint irrigation with biological polysaccharide colloidal solution on pain and the rehabilitation process in patients,after arthroscopic lysis of frozen shoulder.Methods From March 2016 to November 2018,68 patients with frozen shoulder were enrolled and randomly divided into two groups of 34 participants each:The observation and the control groups,respectively.Arthroscopic lysis was performed in both groups.In the observation group,the articular cavity was irrigated with biological polysaccharide colloidal solution after arthroscopic lysis.In the control group,only arthroscopic lysis was performed without the drug irrigation.The average follow-up period of the participants was 7.3months.Visual analogue scale(VAS)score,American Shoulder and Elbow Surgeons(ASES)shoulder score,and University of California at Los Angeles(UCLA)shoulder score were used for evaluation before surgery and 6 months after surgery.The data of both groups were compared to assess the effect of the drug.Results All cases were followed-up.The comparative study of clinical data before surgery and 6 months after surgery,showed that VAS score in the observation group had decreased from(8.1±0.5)points before surgery to(0.9±0.4)points(t=65.564,P<0.05),while that,in the control group,had decreased from(8.3±0.4)points before surgery to(1.0±0.2)points(t=95.183,P<0.05).ASES score in the observation group had improved from(55.4±4.5)points before surgery to(93.3±2.6)points(t=42.522,P<0.05),while that in the control group had improved from(57.1±4.2)points before surgery to(82.5±3.1)points(t=28.372,P<0.05).UCLA score in the observation group had improved from(13.5±2.2)points before surgery to(30.3±1.6)points(t=36.012,P<0.05),while that,of the control group had improved from(12.9±2.4)points before surgery to(27.4±2.1)points(t=26.514,P<0.05).The differences in data before and after surgery between the two groups were statistically significant.Six months after surgery,there was no statistically significant difference in VAS score between the two groups(t=-1.304,P>0.05).The ASES score in the observation group was superior to that in the control group,with statistically significant difference(t=15.565,P<0.05).The UCLA score in the observation group was superior to that in the control group,with statistically significant difference(t=6.405,P<0.05).Conclusion Compared with conventional arthroscopic lysis surgery,irrigation with biological pol ysaccharide colloidal solution can effectively improve the shoulder joint function after surgery and prevent joint readhesion,and therefore it is worthy of clinical application.