微創(chuàng)手術(shù)與藥物治療對早期原發(fā)性凍結(jié)肩患者近期和遠期效果的比較
發(fā)布時間：2019-03-03 14:58
【摘要】：目的比較微創(chuàng)手術(shù)與藥物治療對早期原發(fā)性凍結(jié)肩(PFS)患者的近期和遠期效果。方法選取2014年6月-2015年9月該科收治入院的82例PFS患者為研究對象,隨機分為藥物組與手術(shù)組兩組,各41例。對照組患者行關(guān)節(jié)腔內(nèi)固醇激素注射治療,觀察組患者行關(guān)節(jié)鏡下盂肱關(guān)節(jié)與肩峰下間隙的清理松解術(shù)。比較兩組的基線資料、治療前后的視覺模擬評分(VAS)、Constant肩關(guān)節(jié)評分、內(nèi)旋、外旋、外展、前屈的主動關(guān)節(jié)活動度(ROM)。結(jié)果兩組的基線資料、治療前的VAS評分、Constant肩關(guān)節(jié)評分、主動ROM比較,差異無統(tǒng)計學(xué)意義(P0.05),具有可比性。與治療前相比,兩組患者治療后的VAS評分均明顯降低,Constant肩關(guān)節(jié)評分、主動ROM均明顯升高,差異有統(tǒng)計學(xué)意義(P0.05)。在治療后4周,手術(shù)組患者的VAS評分明顯高于藥物組,Constant肩關(guān)節(jié)評分、主動ROM明顯低于藥物組,差異有統(tǒng)計學(xué)意義(P0.05)。在治療后12周、半年和1年,手術(shù)組患者的VAS評分明顯低于藥物組,Constant肩關(guān)節(jié)評分、主動ROM明顯高于藥物組,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論肩關(guān)節(jié)鏡下微創(chuàng)手術(shù)與藥物注射都是早期PFS患者的有效治療方法,藥物注射的近期療效顯著,但遠期療效較差,而微創(chuàng)手術(shù)的遠期效果更加突出,配合術(shù)后的藥物口服和康復(fù)鍛煉能顯著改善其肩關(guān)節(jié)功能和生活質(zhì)量,值得臨床推廣應(yīng)用。
[Abstract]:Objective to compare the short-term and long-term effects of minimally invasive surgery and drug therapy on early primary frozen shoulder (PFS) patients. Methods 82 patients with PFS admitted to the department from June 2014 to September 2015 were randomly divided into two groups: drug group (n = 41) and operation group (n = 41). The patients in the control group received intraarticular corticosteroids injection and the patients in the observation group underwent arthroscopic clearance of the space between the glenohumeral joint and the subacromial space. Baseline data of the two groups were compared. Visual analogue score (VAS), Constant), shoulder joint score, internal rotation, abduction and anterior flexion of the active joint were evaluated before and after treatment. The active range of motion of the joint was (ROM). Results there was no significant difference between the two groups in baseline data, VAS score before treatment, Constant shoulder joint score and active ROM (P0.05). Compared with the pre-treatment, the VAS scores of the two groups were significantly lower, the Constant shoulder joint score and active ROM were significantly higher than those before treatment, the difference was statistically significant (P0.05). 4 weeks after treatment, the VAS score in the operation group was significantly higher than that in the drug group, and the Constant shoulder joint score and active ROM in the operation group were significantly lower than those in the drug group (P0.05). At 12 weeks, 6 months and 1 year after treatment, the VAS score in the operation group was significantly lower than that in the drug group, and the Constant shoulder joint score and active ROM in the operation group were significantly higher than those in the drug group (P0.05). Conclusion both minimally invasive surgery under shoulder arthroscopy and drug injection are effective methods for the treatment of early PFS patients. The short-term effect of drug injection is remarkable, but the long-term effect is poor, and the long-term effect of minimally invasive surgery is more prominent. Combined with oral medication and rehabilitation exercise, the shoulder joint function and quality of life can be significantly improved, which is worthy of clinical application.
【作者單位】： 山東省臨沂市中心醫(yī)院骨科;
【分類號】：R684
[Abstract]:Objective to compare the short-term and long-term effects of minimally invasive surgery and drug therapy on early primary frozen shoulder (PFS) patients. Methods 82 patients with PFS admitted to the department from June 2014 to September 2015 were randomly divided into two groups: drug group (n = 41) and operation group (n = 41). The patients in the control group received intraarticular corticosteroids injection and the patients in the observation group underwent arthroscopic clearance of the space between the glenohumeral joint and the subacromial space. Baseline data of the two groups were compared. Visual analogue score (VAS), Constant), shoulder joint score, internal rotation, abduction and anterior flexion of the active joint were evaluated before and after treatment. The active range of motion of the joint was (ROM). Results there was no significant difference between the two groups in baseline data, VAS score before treatment, Constant shoulder joint score and active ROM (P0.05). Compared with the pre-treatment, the VAS scores of the two groups were significantly lower, the Constant shoulder joint score and active ROM were significantly higher than those before treatment, the difference was statistically significant (P0.05). 4 weeks after treatment, the VAS score in the operation group was significantly higher than that in the drug group, and the Constant shoulder joint score and active ROM in the operation group were significantly lower than those in the drug group (P0.05). At 12 weeks, 6 months and 1 year after treatment, the VAS score in the operation group was significantly lower than that in the drug group, and the Constant shoulder joint score and active ROM in the operation group were significantly higher than those in the drug group (P0.05). Conclusion both minimally invasive surgery under shoulder arthroscopy and drug injection are effective methods for the treatment of early PFS patients. The short-term effect of drug injection is remarkable, but the long-term effect is poor, and the long-term effect of minimally invasive surgery is more prominent. Combined with oral medication and rehabilitation exercise, the shoulder joint function and quality of life can be significantly improved, which is worthy of clinical application.
【作者單位】： 山東省臨沂市中心醫(yī)院骨科;
【分類號】：R684
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