魏氏伤科导引联合关节镜手术治疗原发性冻结肩的疗效分析

Analysis of the curative effect of Wei's traumatology guidance combined with arthroscopic surgery in the treatment of primary frozen shoulder

目的观察魏氏伤科导引联合肩关节镜手术治疗原发性冻结肩的临床疗效。方法回顾性分析2018年8月-2019年9月上海中医药大学附属市中医医院骨伤科收治的全麻下行肩关节镜手术后的86例原发性冻结肩患者的临床资料,根据锻炼方法分为导引组(n=43)和对照组(n=43)。导引组术后采用魏氏伤科导引锻炼,对照组术后采用常规肩关节功能锻炼。随访6个月,记录术前及末次随访时患者的疼痛视觉模拟评分、肩关节功能评分及满意度评分,分析其疗效。结果2组术前VAS评分差异无统计学意义(P>0.05);2组术后6个月VAS评分均明显低于同组术前(P<0.05),而2组间VAS评分差异无统计学意义(P>0.05)。2组术前CMS评分差异无统计学意义(P>0.05);2组术后6个月CMS评分均明显高于同组术前(P<0.05),但导引组CMS评分显著高于对照组(P<0.05)。术后6个月满意度评分,导引组为(8.24±0.52)分,对照组为(5.55±0.02)分,导引组明显高于对照组(P<0.05)。结论魏氏伤科导引联合关节镜手术治疗原发性冻结肩,能有效改善肩关节活动度,提高患者整体满意度。

Objective To study the curative effect of Wei's traumatology guidance combined with arthroscopic sur-gery in the treatment of primary frozen shoulder.Methods The clinical data of 86 patients with primary frozen shoulder after shoulder arthroscopic surgery under general anesthesia treated in the Department of Orthopaedics and Traumatology,Shanghai Municipal Hospital of TCM Affiliated to Shanghai University of Traditional Chinese Medicine from August 2018 to September 2019 were retrospectively analyzed.They were divided into guidance group(n=43)and control group(n=43)according to the exercise method.After operation,the guidance group exercised under the guidance of Wei's traumatology,and the control group received routine shoulder function exercise.The patients were followed up for 6 months.The pain visual analog score,shoulder function score and satisfaction score were compared between the two groups before operation and at the last follow-up.Results The preoperative VAS score of the two groups were not statistically different(P>0.05).The VAS scores of the two groups at 6 months after the surgery were significantly lower than those of the same group before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).The preoperative constant-murley score(CMS)scores of the two groups were not statistically different(P>0.05).The CMS scores of the two groups at 6 months after the surgery were significantly higher than those of the same group before surgery(P<0.05),and the CMS scores of the guidance group were significantly higher than those of the control group(P<0.05).Six months after operation,the score of satisfaction of the guidance group(8.24±0.52)was higher than that of the control group(5.55±0.02)(P<0.05).Conclusion Wei's traumatology guidance combined with arthroscopic surgery for the treatment of primary frozen shoulder can effectively increase the range of motion of shoulder joint,improve the overall satisfaction of patients.