超声引导下富血小板血浆多点注射治疗原发性冻结肩的疗效研究

Efficacy Study of Ultrasound-guided Multi-point Injection of Platelet-rich Plasma in the Treatment of Primary Frozen Shoulder

目的观察超声引导下富血小板血浆(platelet-richplasma,PRP)多点注射治疗原发性冻结肩的临床疗效。方法选取2019-01/2021-12月符合入选标准的64例原发性冻结肩患者,根据患者意愿及日常生活需求分为PRP治疗组和非PRP治疗组,每组各32例患者。PRP治疗组患者给予超声引导下肩峰下滑囊、喙肱韧带、肩关节腔PRP注射;非PRP治疗组患者仅给予对症支持治疗。采用视觉模拟量表(visual analogue scale,VAS)评分,Constant-murley肩关节功能评分和关节活动度(rangeof motion,ROM)评价治疗前后肩关节功能情况。结果两组患者治疗前肩关节VAS评分差异无统计学意义(P>0.05),治疗后PRP治疗组各时间点(1周、6周、3个月)VAS评分均低于非PRP治疗组,组间比较差异具有统计学意义(P均<0.05)。此外,两组患者治疗后的肩关节VAS评分有明显下降趋势,且较治疗前明显降低(P均<0.05)。两组患者治疗前肩关节Constant-murley评分,前屈、外展、外旋角度差异无统计学意义(P>0.05),治疗后各时间点(1周、6周、3个月)PRP治疗组患者肩关节Constant-murley评分,前屈、外展、外旋角度均高于非PRP治疗组(P均<0.05)。两组患者治疗后肩关节Constant-murley评分,前屈、外展、外旋角度有明显升高趋势,且较治疗前明显升高(P均<0.05)。结论超声引导下PRP多点注射能有效减少冻结肩患者的疼痛,改善肩关节功能。

Objective To observe the clinical efficacy of ultrasound-guided multi-point injection of platelet-rich plasma(PRP)in the treatment of primary frozen shoulder.Methods A total of 64 patients with primary frozen shoulder who met the inclusion criteria from January 2019 to December 2021 were selected,and the patients were divided into PRP treatment group and non-PRP treatment group,with 32 patients in each,according to the patients′wishes and daily life needs.Patients in PRP treatment group received ultrasound-guided injection of PRP into the subacromial bursa,coracohumeral ligament and shoulder joint cavity;patients in non-PRP treatment group were only given symptomatic and supportive treatment.The shoulder function was evaluated by visual analogue scale(VAS),Constant-murley score and range of motion(ROM)before and after treatment.Results There was no significant difference in VAS score of shoulder joint between the two groups before treatment(P>0.05).The VAS score of PRP treatment group were lower than those of non-PRP treatment group at each timing(1 week,6 weeks and 3 months)after treatment,and the differences between the two groups were statistically significant(all P<0.05).In addition,the shoulder joint VAS score of the two groups after treatment had a significant downward trend,which were significantly lower than those before treatment(all P<0.05).There was no significant difference in Constant-murly score and the forward flexion,abduction and external rotation angles of shoulder joint between the two groups before treatment(P>0.05),the Constant-murly score and forward flexion,abduction and external rotation angles of shoulder joint in PRP treatment group were higher than those in non-PRP treatment group at each timing(1 week,6 weeks and 3 months)after treatment(all P<0.05).Constant-murly score and the forward flexion,abduction and external rotation angles of shoulder joint in the two groups showed a significant upward trend,and were significantly higher than those before treatment(all P<0.05).Conclusion Ultrasound-guided PRP multi-point injection can effectively reduce the pain of patients with frozen shoulder and improve the function of shoulder joint.