超声引导下单点穿刺法行多部位注射治疗冻结肩疗效观察

Effectiveness of single‑segment puncture for ultrasound‑guided multi‑site injection in the treatment of frozen shoulder

目的比较超声引导下单点穿刺注射法与传统多点穿刺注射法治疗冻结肩的临床疗效。方法门诊接受注射治疗的100例冻结肩患者,采用随机数字表法将患者分为单点穿刺组(S组)和多点穿刺组(M组),每组50例。两组患者均接受超声引导下盂肱关节腔联合肩峰下滑囊及肱二头肌长头腱鞘注射治疗。记录治疗前和治疗后第4周、第8周、第12周肩关节的数字分级评分法(Numerical Rating Scale,NRS)疼痛评分、主动活动范围(active range of motion,AROM)评价结果以及睡眠状况自评量表(Self-Rating Scale of Sleep,SRSS)总分。同时记录两组患者注射治疗操作时长、患者对治疗的满意度、治疗后镇痛药物使用率以及治疗后各时间点患者恢复满意度。结果与治疗前比较:两组患者治疗后各时间点NRS评分和SRSS总分均明显降低(P<0.05),治疗后各时间点AROM中前屈、后伸、外展和体侧外旋的角度以及后伸内旋评分均明显升高(P<0.05)。S组治疗后各时间点NRS评分、SRSS总分、AROM、治疗后镇痛药物使用率以及患者恢复满意度与M组比较,差异均无统计学意义(P>0.05);S组注射治疗平均操作时长为(3.5±0.8)min,明显短于M组(5.6±1.1)min(P<0.05);S组患者对治疗的满意度评分更高(P<0.05)。结论超声引导下单点穿刺法行多部位注射治疗冻结肩的临床疗效非劣效于传统多点注射法,临床操作时长更短,患者的满意度更高。

Objective To compare the effectiveness between single⁃segment and traditional multi⁃segment puncture for ultrasound⁃guided injection in patients with frozen shoulder.Methods A total of 100 patients with frozen shoulder who received in⁃jection treatment in our clinic were enrolled.They were divided into two groups according to random number table method(n=50):a single⁃segment group(group S)and a multiple⁃segment group(group M).Both groups underwent ultrasound⁃guided injection at the gle⁃nohumeral joint combined with subacromial bursa plus biceps long⁃head tendon.The Numerical Rating Scales(NRS)pain scores,ac⁃tive range of motion(AROM),and Self⁃Rating Scale of Sleep(SRSS)scores were recorded before treatment and Weeks 4,8 and 12 af⁃ter treatment.Meanwhile,the time used for injection,patient satisfaction with treatment,the use of analgesics and patient satisfaction with recovery at each time point after treatment were also recorded.Results Compared with those before treatment,the NRS and SRSS scores of the two groups significantly decreased at each time point after treatment(P<0.05).Improvement of AROM including for⁃ward flexion,extension,abduction and body external rotation,and the extension and internal rotation scores was observed at different time points after treatment(P<0.05).Compared with group M,there were no significant differences in NRS,SRSS,AROM,the use of analgesics and patient satisfaction with recovery in group S(P>0.05).The time used for injection in group S[(3.5±0.8)min]was signifi⁃cantly shorter than that in group M[(5.6±1.1)min](P<0.05).Patient satisfaction with injection in group S was significantly higher than that in group M(P<0.05).Conclusions Ultrasound⁃guided single⁃segment puncture can be applied for multi⁃segment injection in patients with frozen shoulders,with non⁃inferior clinical effectiveness,shorter clinical practice time and higher patient satisfaction.