超声引导下穿刺减压联合体外冲击波疗法治疗肩袖钙化性肌腱炎短期疗效观察

Short-term efficacy of ultrasound-guided puncture decompression combined with extracorporeal shock wave therapy in treatment of rotator cuff calcified tendinitis

目的:探讨超声引导下穿刺减压联合体外冲击波疗法(ESWT)治疗肩袖钙化性肌腱炎(RCCT)的短期疗效。方法:选择RCCT患者57例(60个患肩),随机分为试验组(30个患肩)和对照组(30个患肩)。试验组采用超声引导下穿刺减压联合ESWT治疗。对照组行超声引导下穿刺减压治疗。比较两组患者短期临床疗效,治疗前后肩关节视觉模拟量表(VAS)评分、Constant-Murley及美国加州大学(UCLA)肩关节功能评分,以及不良反应发生情况。结果:试验组治疗总有效率高于对照组(P<0.05)。治疗前,两组患者肩关节VAS评分、活动度(外展、外旋、前屈、内旋)评分以及UCLA肩关节功能评分比较差异无统计学意义(均P>0.05)。治疗后,两组患者肩关节VAS评分低于治疗前,且试验组低于对照组(均P<0.05);肩关节活动度(外展、外旋、前屈、内旋)评分及UCLA肩关节功能评分高于治疗前,且试验组高于对照组(均P<0.05)。两组患者均未发生严重不良反应,术后均无肩关节粘连、肩袖或神经损伤、穿刺部位感染等并发症。结论:超声引导下穿刺减压联合ESWT治疗肩袖钙化性肌腱炎具有良好的临床疗效,与单一超声引导下钙化灶穿刺减压相比能更好地减轻疼痛,恢复肩功能。

Objective:To investigate the short-term efficacy of ultrasound-guided puncture decompression combined with extracorporeal shock wave therapy(ESWT)in the treatment of rotator cuff calcified tendinitis(RCCT).Methods:57 patients(60 shoulders)with RCCT were randomly divided into experimental group(30 shoulders)and control group(30 shoulders).The experimental group was treated with ultrasound-guided puncture decompression combined with ESWT.The control group was treated with ultrasound-guided puncture decompression.The short-term clinical efficacy,shoulder visual analogue scale(VAS)score,Constant-Murley and UCLA shoulder function scores before and after treatment,and adverse reactions were compared between the two groups.Results:The total effective rate of the experimental group was higher than that of the control group(P<0.05).Before treatment,there was no significant difference in shoulder VAS score,range of motion(abduction,external rotation,forward flexion and internal rotation)score and UCLA shoulder function score between the two groups(all P>0.05).After treatment,the VAS score of shoulder joint in the two groups was lower than that before treatment,and that in the experimental group was lower than that in the control group(all P<0.05);the scores of shoulder range of motion(abduction,external rotation,forward flexion and internal rotation)and UCLA shoulder function were higher than those before treatment,and those of the experimental group were higher than thoset of the control group(all P<0.05).There were no serious adverse reactions in both groups.There were no complications such as shoulder joint adhesion,rotator cuff or nerve injury,puncture site infection and so on.Conclusion:Ultrasound-guided puncture decompression combined with ESWT has a good clinical effect in the treatment of RCCT.Compared with single ultrasound-guided puncture decompression,it can better reduce pain and restore shoulder function.