麻醉下石氏伤科松解术治疗冻结肩对肩部重要肌腱和韧带弹性的影响

Effect of Shi's Traumatology Treatment of Frozen Shoulder for Loosening Procedure under Anesthesia on the Key Shoulder Tendons and Ligaments

目的:探讨麻醉下石氏伤科松解术治疗冻结肩对肩部重要肌腱和韧带弹性的影响。方法:共纳入75例冻结肩单侧发病患者,患侧肩为观察组,健侧肩为对照组,在治疗前、治疗后第2周和第4周对患肩进行Constant-Murley肩关节功能评分和视觉模拟量表(VAS)评分,并使用Supersonic AixPlorer超声诊断仪采集患者双肩冈上肌腱、喙肱韧带、冈下肌腱的弹性模量值。采用中位数和四分位数距来描述数据的统计特征;采用配对样本秩和检验来进行假设检验,比较治疗前健侧肩和患侧肩之间弹性模量值的差异;采用Spearman相关性分析法分析弹性模量值与Constant-Murley肩关节功能评分的相关性。结果:治疗前患侧肩和健侧肩弹性模量值差异有统计学意义(P<0.001);患者的Constant-Murley肩关节功能评分在治疗后有所提升,VAS评分明显下降,差异有统计学意义(P<0.05);患侧肩弹性模量值与肩关节功能评分负相关(P<0.001)。结论:冻结肩患者患肩的冈上肌腱、喙肱韧带、冈下肌腱相对于健肩弹性模量值有所升高;麻醉下石氏伤科松解术可以提高冻结肩患者的肩关节功能,改善患者疼痛情况,改善肩关节组织弹性。

Objective:To investigate the effect of Shi's traumatology treatment of frozen shoulder for loosening procedure under anesthesia on the elasticity of key tendons and ligaments of the shoulder.Methods:75 patients with unilateral onset of frozen shoulder were included in this study,with the affected shoulder as the observation group and the healthy shoulder as the control group.Constant-Murley shoulder function scores and visual analogue scale(VAS)scores were performed on the affected shoulders before treatment,2 weeks and 4 weeks after treatment,and the Young's modulus values of the supraspinatus tendon,rostro-humeral ligament,and infraspinatus tendon of the patients'bilateral shoulders were collected using Supersonic AixPlorer ultrasonic diagnostic instrument.Median and interquartile distance were used to characterize the statistics of the data.The paired-samples rank-sum test was used for hypothesis testing to compare the differences in Young's modulus values between the healthy and affected shoulders before treatment.Spearman correlation analysis was used to correlate Young's modulus values with Constant-Murley shoulder function scores.Results:The difference in Young's modulus values between the affected shoulder and the healthy shoulder before treatment was statistically significant(P<0.001).After treatment,the patients'Constant-Murley shoulder function scores improved,and the VAS scores decreased significantly,with a statistically significant difference(P<0.05).The Young's modulus values of the affected shoulder were negatively correlated with the shoulder function scores(P<0.001).Conclusion:The Young's modulus of supraspinatus tendon,rostro-humeral ligament,and infraspinatus tendon of the affected shoulder in patients with frozen shoulder had elevated values relative to that of the healthy shoulder.Shi's traumatology treatment of frozen shoulder for loosening procedure under anesthesia can improve the shoulder function of patients with frozen shoulder,improve the patient's pain,and improve the elasticity of the shoulder joint tissues.