肌骨超声引导下高渗葡萄糖治疗肩袖损伤的前瞻性研究

Comparative study of hypertonic glucose and triamcinolone acetonide injection under ultrasound guidance in the treatment of rotator cuff injury

目的 观察肌骨超声引导下高渗葡萄糖治疗肩袖损伤的疗效。方法 收集2019年10月至2021年4月就诊于我院康复医学科门诊行肌骨超声引导下注射治疗的肩袖损伤患者。按随机数字表法分为高糖组和激素组。高糖组应用25%浓度高渗葡萄糖;激素组应用曲安奈德注射液。分别于治疗前、治疗1次后、治疗3次后、治疗3个月后给予疼痛视觉模拟评分(visual analogue scale,VAS)、加州大学肩关节评分系统(UCLA评分系统)、肩关节主动前屈关节活动度(active flexion range of motion,AFROM)和主动外展关节活动度(active abduction range of motion,AAROM)进行比较。结果 共收入患者50例,两组各25例。与治疗前相比,两组患者治疗1次后、治疗3次后、治疗3个月后VAS评分、UCLA评分及AFROM、AAROM度数均显著改善(P <0.05)。激素组在治疗1次后疗效最为明显,治疗3次后和治疗3个月后疗效持续好转;高糖组在治疗3个月后疗效较治疗1次后更明显(P <0.05)。两组治疗1次后、治疗3次后、治疗3个月后疗效,激素组较高糖组效果更优(P <0.05)。结论 肌骨超声引导下注射高渗葡萄糖与曲安奈德注射液对肩袖损伤均有效,但注射后3个月内激素组较高糖组疗效佳。

Objective To investigate the effect of hypertonic glucose and triamcinolone acetonide injection under ultrasound guidance in the treatment of rotator cuff injury.Methods A series of 50 patients with rotator cuff injury treated by ultrasound-guided injection in the outpatient department of rehabilitation medicine of our hospital from October 2019 to April 2021 were collected.According to the types of injected drugs,they were divided into high glucose group and hormone group.The high glucose group was treated with 25%hypertonic glucose;the hormone group was treated with triamcinolone acetonide.Therapy was given before treatment,immediately after the first treatment,after a course of treatment and 3 months after a course of treatment.VAS,University of California at Los Angeles scoring system,AFROM and AAROM were compared.Results There were 50 patients in total,with 25 patients in each group.Compared with the data before treatment,VAS,UCLA score,AFROM and AAROM were significantly improved immediately after the first treatment,after a course of treatment and 3 months after a course of treatment(P<0.05);The immediate curative effect of hormone group was the most obvious after the first treatment and it continued to improve after one course of treatment,which maintained for 3 months after one course of treatment;the curative effect of high glucose group 3 months after a course of treatment was significantly better than that immediately after treatment(P<0.05).The effect of hormone group was better than that of high glucose group immediately after the first treatment,after a course of treatment and 3 months after a course of treatment.Conclusions Both hypertonic glucose injection and triamcinolone acetonide injection under ultrasound guidance have curative effect on rotator cuff injury.However,the short-term and long-term effect of hypertonic glucose injection is superior than triamcinolone acetonide injection.