中老年原发性冻结肩患者全麻下手法松解结合关节内注射治疗

Analysis of the effect of manual release combined with intra-articular injection in the treatment of elderly patients with primary frozen shoulder under general anesthesia

目的探讨全麻下手法松解结合关节内注射治疗中老年原发性冻结肩的方法并评价其疗效。方法回顾分析2016年6月至2020年1月我院骨科采用全麻下手法松解结合肩峰下注射治疗的49例中老年原发性冻结肩的临床资料,其中男19例,女30例;年龄48~71岁,平均53.8岁。采用疼痛视觉模拟评分(visual analogue scale,VAS)、Constant-Murley评分对患者进行术前、术后3个月、1年评估。结果所有病例都得到随访,肩部疼痛和功能障碍均明显改善,VAS评分:术前(7.8±1.1)分,术后1年(1.9±0.8)分,差异有统计学意义(P<0.01)。Constant-Murley评分:术前为(60.4±7.3)分,术后1年复查为(90.2±2.6)分,差异有统计学意义(P<0.01)。结论全麻下手法松解结合肩峰下注射治疗可以极大地缩短冻结肩的病程,快速缓解疼痛,恢复肩关节功能。

Objective To explore the effect of manual release combined with intra-articular injection in the treatment of primary frozen shoulder in the elderly under general anesthesia.Methods The clinical data of 49 middle-aged and elderly patients with primary frozen shoulder were retrospectively analyzed,and all treated by manual release under general anesthesia combined with subacromial injection in Orthopedic Department of our hospital from June 2016 to January 2020.There were 19 males and 30 females with an average of 53.8 years(range:48-71 years).The VAS score and Constant-Murley score were used to evaluate the patients before operation,3 months after operation and 1 year after operation.Results All cases were followed up,and the shoulder pain and dysfunction were significantly improved.The average VAS score was(7.8±1.1)before operation and(1.9±0.8)1 year after operation.The average Constant-Murley score was(60.4±7.3)before operation and(90.2±2.6)1 year after operation.Conclusions Manipulation release combined with subacromial injection under general anesthesia can greatly shorten the course of frozen shoulder,quickly relieve pain and restore shoulder joint function.