超声引导下注射类固醇联合深层肌肉刺激治疗脑卒中偏瘫后肩痛患者的疗效观察

Efficacy of ultrasound-guided Steroid injection combined with deep muscle stimulation in the treatment of post-stroke hemiplegia patients with shoulder pain

目的探讨超声引导下注射类固醇联合深层肌肉刺激对脑卒中偏瘫后肩痛患者上肢功能与肩关节活动度的影响,以期为临床诊治提供有效参考依据。方法按照随机数字表法将广西壮族自治区江滨医院2021年4月至2022年2月收治的160例脑卒中偏瘫后肩痛患者分为两组,各80例。对照组患者采用超声引导下注射类固醇治疗,研究组患者在对照组的基础上进行深层肌肉刺激治疗,两组患者均治疗3个月。比较两组患者临床疗效,治疗前后上肢感觉神经传导速度、运动神经传导速度,治疗前与治疗1、3个月后上肢功能障碍评定量表(DASH)、疼痛数字评价量表(NRS)、Barthel指数(BI)评分,以及治疗前后肩关节前屈、外展、外旋角度。结果治疗后研究组患者的临床总有效率高于对照组;治疗后两组患者感觉神经传导速度、运动神经传导速度均高于治疗前,且研究组高于对照组;与治疗前比,治疗1、3个月后两组患者DASH、NRS评分均呈降低趋势,研究组低于对照组,而BI评分均呈升高趋势,研究组高于对照组;治疗后两组患者肩关节前屈、外展、外旋角度均大于治疗前,且研究组大于对照组(均P<0.05)。结论超声引导下注射类固醇联合深层肌肉刺激治疗脑卒中偏瘫后肩痛可提高患者临床疗效,改善神经传导速度与上肢功能,降低患者疼痛程度,同时提高生活质量。

Objective To investigate the effects of ultrasound-guided Steroid injection combined with deep muscle stimulation on upper limb function and shoulder range of motion in post-stroke hemiplegia patients with shoulder pain, providing reference for clinical treatment.Methods According to the random number table method, 160 post-stroke hemiplegia patients with shoulder pain who were admitted to Jiangbin Hospital of Guangxi Zhuang Autonomous Region from April 2021 to February 2022 were divided into two groups, 80 cases in each group. Patients in the control group were treated with ultrasound-guided Steroid injection, patients in the study group were treated with deep muscle stimulation on the basis of the control group, patients in both groups were treated for 3 months. Clinical efficacy of patients after treatment, sensory nerve conduction velocity and motor nerve conduction velocity of upper limbs before and after treatment, upper limb disability arm shoulder hand(DASH), numerical rating scale(NRS), Barthel index(BI) score before treatment and after 1 and 3 months of treatment, and the angle of shoulder flexion, abduction and external rotation before and after treatment were compared between the two groups. Results After treatment, the clinical total effective rate of the patients in the study group was higher than that in the control group;after treatment, the sensory nerve conduction velocity and motor nerve conduction velocity of the two groups were higher than those before treatment, and the study group was higher than the control group;compared with before treatment, after 1 and 3 months of treatment, the DASH and NRS scores of the two groups showed a decreasing trend, and the study group was lower than the control group, the BI scores showed an increasing trend, and the study group was higher than the control group;after treatment, the angles of shoulder flexion, abduction and external rotation of the two groups of patients were all greater than those before treatment, and the study group was greater than the control group(all P<0.05). Conclusion Ultrasound-guided Steroid injection combined with deep muscle stimulation in the treatment of post-stroke hemiplegia patients with shoulder pain can improve the clinical efficacy of patients, improve nerve conduction velocity and upper limb function, reduce pain in patients, and improve quality of life.