偏瘫后肩痛肩关节肌骨超声征象与疼痛程度相关性研究

Study on the correlation between the musculoskeletal ultrasound of shoulder joint and the degree of pain after hemiplegia

目的:研究偏瘫后肩痛(hemiplegic shoulder pain,HSP)患者疼痛视觉模拟评分法(visual analogue scale,VAS)与肩关节肌骨超声征象相关性。方法:回顾性分析2019年10月—2020年8月我院32例偏瘫肩痛患者为研究组;同期30例非肩痛患者为对照组,两组均行V A S及肌骨超声检查肩关节冈上肌肌腱厚度、冈上肌微血流(B-Flow)、肩峰下滑囊积液(SASD)、肱二头肌长头腱腱鞘积液(LHB)、盂肱关节后方滑囊厚度(PCT)。结果:研究组冈上肌B-Flow、SASD、LHB、PCT均大于对照组,冈上肌厚度无统计学差异(P>0.05);Pearson相关性分析PCT与VAS评分呈高度正相关(P<0.05);SASD、LHB与VAS评分呈低度正相关(P<0.05);冈上肌B-Flow与VAS评分无相关性(P>0.05)。结论:偏瘫肩痛患者SASD、LHB、PCT与肩关节疼痛程度有高度相关性,可作为评估偏瘫肩痛治疗效果的重要指标。

Objective To investigate the correlation between visual analogue scale(VAS)and musculoskeletal ultrasound signs of shoulder in patients with hemiplegic shoulder pain(HSP).Methods Retrospective analysis of 32 cases of hemiplegic shoulder pain were the study group,and 30 cases of non-shoulder pain were the control group,the two groups were tested for the thickness of the shoulder joint by VAS and musculoskeletal ultrasound,microflow(B-Flow)in supraspinatus,subacromial-subdeltoid bursa effusion(SASD),Tendon sheath effusion of biceps brachii longus(LHB),posterior capsule thickness(PTC).Results The B-flow in supraspinatus,SASD,LHB and PTC in the study group were all higher than those in the control group,and there was no statistical difference in the thickness of supraspinatus muscle between the two groups.Pearson correlation analysis showed that PTC was highly positively correlated with the VAS score,while the SASD and LHB were slightly positively correlated with the VAS score;There was no correlation between B-flow in supraspinatus muscle and VAS score.Conclusion In patients with HSP,musculoskeletal ultrasound detection of SASD,LHB,PTC are highly correlated with the degree of shoulder pain,which can be used as an important index to evaluate the treatment effect of hemiplegia shoulder pain.