密集型银质针联合手法松解术治疗慢性肩袖损伤的临床研究

Clinical Study on Treatment of Chronic Rotator Cuff Injury with Dense Silver Needles Combined with Manipulative Release

目的:观察臂丛神经阻滞下手法松解结合银质针治疗慢性肩袖损伤的临床疗效和安全性。方法:选择28例慢性肩袖损伤患者,随机均分为观察组(14例)和对照组(14例),观察组采用超声引导下臂丛神经阻滞手法松解结合银质针治疗,对照组采用超声引导下臂丛神经阻滞手法松解治疗。采用视觉模拟量表(VAS)评分、肩关节活动度及加州大学洛杉矶分校(UCLA)肩关节评分系统评定两组患者的临床疗效。记录不良反应及并发症,评价其安全性。结果:两组患者治疗前VAS评分差异无统计学意义(P>0.05);两组患者VAS评分在治疗后1周、1个月和3个月均显著低于治疗前,差异有统计学意义(P<0.05);观察组患者VAS评分在治疗后1周和1个月均显著低于对照组,差异均有统计学意义(P<0.05)。两组患者治疗前肩关节活动度的差异无统计学意义(P>0.05);治疗后1周,观察组患者前屈、外展和后伸活动度明显大于对照组,差异有统计学意义(P<0.05);治疗后1个月,观察组患者外展和后伸活动度均明显大于对照组,差异有统计学意义(P<0.05);治疗后3个月,观察组患者后伸活动度明显大于对照组,差异有统计学意义(P<0.05)。两组患者治疗前UCLA评分差异无统计学意义(P>0.05);治疗后1周、1个月和3个月,两组患者UCLA评分均显著高于治疗前,差异有统计学意义(P<0.05);治疗后1周、1个月和3个月,观察组患者UCLA评分显著高于对照组,差异有统计学意义(P<0.05)。结论:超声引导下臂丛神经阻滞手法松解结合银质针治疗慢性肩袖损伤,能显著改善患者肩关节功能和疼痛,安全性较高,值得推广和临床应用。

Objective:To observe the clinical efficacy and safety of the treatment of chronic rotator cuff injury by manipulation under the brachial plexus combined with silver needles.Methods:28 cases of chronic rotator cuff injury were selected.They were randomly divided into the observation group(14 cases)and the control group(14 cases).The observation group was treated with ultrasound-guided brachial plexus block under manipulative release+silver needles,and the control group was treated with ultrasound-guided brachial plexus block under manipulative release.Visual analogue scale(VAS),shoulder joint mobility and University of California at Los Angeles(UCLA)shoulder joint scoring system were used to evaluate the clinical efficacy of the two groups of patients.Adverse reactions and complications were recorded,and their safety was evaluated.Results:There was no statistically significant difference in VAS scores between the two groups of patients before treatment(P>0.05).The VAS score of the observation group was significantly lower than that of the control group at 1 week,1 month and 3 months after treatment(P<0.05).There was no statistically significant difference in the comparison of shoulder joint mobility between the two groups of patients before treatment(P>0.05).After one week's treatment,the observation group showed significantly greater flexion,abduction,and extension than the control group(P<0.05).One month after treatment,the abduction and extension of the observation group were significantly greater than those of the control group(P<0.05).After 3 months'treatment,the extension of the observation group was significantly greater than that of the control group(P<0.05).There was no significant difference in UCLA scores between the two groups before treatment(P>0.05).The UCLA scores of the two groups at 1 week,1 month and 3 months after treatment were significantly higher than those before treatment,and the difference was statistically significant(P<0.05).However,the UCLA scores of the observation group at 1 week,1 month and 3 months after treatment were significantly higher than those of the control group,and the difference was statistically significant(P<0.05).Conclusion:The treatment of chronic rotator cuff injury with ultrasound-guided brachial plexus manipulative release combined with silver needles can significantly improve the shoulder joint function and pain in patients with high safety,which is worthy of promotion and clinical application.