臂丛麻醉下石氏手法松解术治疗继发性凝肩临床疗效观察

Clinical Observation of SHI’s Manipulation Release under Brachial Plexus Anesthesia in the Treatment of Secondary Frozen Shoulder

目的探讨臂丛麻醉下石氏手法松解术治疗继发性凝肩的临床疗效。方法将136例继发性凝肩患者按随机数字表法分为试验组和对照组,每组68例,其中试验组予臂丛麻醉下石氏手法松解术治疗,对照组予塞来昔布治疗,并将功能锻炼作为两组的基础治疗。分别于治疗前和治疗开始后1 d、2周、4周、12周比较两组患者的肩关节各方向活动度、“简式Mcgill”疼痛评分及Constant-Murley肩关节功能评分,并记录患者的不良反应发生情况。结果最终试验组67例、对照组66例获得随访。试验组总有效率为97.01%(65/67),高于对照组的77.27%(51/66)(P<0.05)。治疗后两组患者的肩关节各方向活动度及Constant-Murley肩关节功能评分均较治疗前明显改善,“简式Mcgill”疼痛评分均明显低于治疗前(P<0.05),且试验组优于对照组。研究期间仅对照组1人因口服塞来昔布出现明显的恶心腹胀等胃肠道反应而退出。结论臂丛麻醉下石氏手法松解术治疗继发性凝肩的临床疗效更好。

Objective To investigate the clinical effect of SHI’s manipulation release under brachial plexus anesthesia in the treatment of secondary frozen shoulder.Methods 136 patients with secondary frozen shoulder were randomly divided into experimental group and control group,68 cases in each group.The experimental group was treated with SHI’s manual release under brachial plexus anesthesia,while the control group was treated with celecoxib,and functional exercise was taken as the basic treatment of the two groups.Before treatment and 1 day,2 weeks,4 weeks and 12 weeks after treatment,the range of motion of shoulder joint in all directions,short McGill pain score and constant murley shoulder function score were compared between the two groups,and the incidence of adverse reactions was recorded.Results 67 cases in the experimental group and 66 cases in the control group were followed up.The total effective rate of the experimental group was 97.01%(65/67),which was higher than 77.27%(51/66)of the control group(P<0.05).After treatment,the range of motion and constant murley shoulder function score of the two groups were significantly improved,and the“simple McGill”pain score was significantly lower than that before treatment(P<0.05),and the experimental group was better than the control group.During the study period,only one person in the control group withdrew from the study due to obvious nausea,abdominal distension and other gastrointestinal reactions caused by oral celecoxib.Conclusion Under brachial plexus anesthesia,the clinical effect of SHI’s manipulation release in the treatment of secondary frozen shoulder is better.