中老年人群原发性冻结肩发病的潜在危险因素及手术预测因素的调查分析

Investigation and analysis of potential risk factors and surgical predictive factors for the onset of primary frozen shoulder in middle-aged and elderly population

目的:调查原发性冻结肩患者的流行病学特征及接受手术的影响因素。方法:2015年1月至2020年6月因冻结肩就诊的患者1086例,按照纳入及排除标准筛选后,最终入组原发性冻结肩患者98例。选取同期进行常规体检的健康人群100例进行年龄匹配后作为对照。对比分析两组的人群特征、并发症、原发性冻结肩患者中接受关节镜下手术治疗及保守治疗患者的差异,分析判定影响原发性冻结肩患者接受手术的因素。结果:两组患者性别、肩部外伤史、合并糖尿病或高脂血症有明显差异(P<0.05)。患者年龄、夜间痛、疼痛持续时间及双侧肩关节同时受累与患者是否接受手术治疗明显相关(P<0.05)。另外,与高血压及高脂血症患者相比,糖尿病患者更易接受手术(P<0.05)。结论:性别、肩部外伤史、糖尿病和高脂血症与原发性冻结肩的发病密切相关。年轻患者、糖尿病患者、夜间疼痛症状明显患者、持续时间长且双侧肩关节同时受累的患者更易接受手术治疗。

Objective:This study aimed to investigate the epidemiological characteristics of patients with idiopathic frozen shoulder and identify factors associated with surgical intervention.Methods:A total of 1086 patients presenting frozen shoulder at the Department of Orthopedics,Shaanxi Provincial People's Hospital,between 2015 and 2020 were initially identified.After applying inclusion and exclusion criteria,98 patients with idiopathic frozen shoulder were included in the study.One hundred age-matched healthy individuals who received routine medical examinations during the same period were enrolled as the control group.Demographic characteristics,complications,and the proportion of patients receiving arthroscopic surgery or conservative treatment were compared between the two groups.Factors associated with surgical intervention were identified with logistic regression analysis.Results:There were significant differences between the two groups in terms of gender,history of shoulder trauma,and comorbidities such as diabetes or hypercholesterolemia(P<0.05).Age,night pain,duration of symptom and bilaterality of patients were significantly associated with the likelihood of receiving surgery for idiopathic adhesive capsulitis(P<0.05).Furthermore,diabetic patients were also more likely to receive surgery compared with hypertension and hypercholesterolemia patients(P<0.05).Conclusions:Gender,history of shoulder trauma,diabetes and hypercholesterolemia were significantly associated with idiopathic frozen shoulder.Additionally,younger and diabetic patients,or patients with unbearable night pain,longer duration of symptoms,and bilateral shoulder involvement were more likely to receive surgical treatment.