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中华关节外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (06) : 752 -755. doi: 10.3877/cma.j.issn.1674-134X.2020.06.018

所属专题: 文献

临床经验

肩袖撕裂保守治疗的临床疗效观察
韩长旭1, 张婷1, 王婧娟2,(), 孔令跃1, 额尔顿图1, 任逸众1   
  1. 1. 010030 呼和浩特,内蒙古医科大学第二附属医院关节镜与运动医学外科
    2. 010030 呼和浩特,内蒙古医科大学第二附属医院康复科
  • 收稿日期:2017-03-11 出版日期:2020-12-01
  • 通信作者: 王婧娟
  • 基金资助:
    内蒙古自治区自然科学基金资助项目(2017MS0851)

Clinical results of conservative treatment for rotator cuff tear

Changxu Han1, Ting Zhang1, Jingjuan Wang2,(), Lingyue Kong1, Eerduntu1, Yizhong Ren1   

  1. 1. Department of Arthroscopy and Sports Medicine, The Second Hospital of Inner Mongolia Medical University, Inner Mongolia Huhehot 010030, China
    2. Rehabilitation Department, The Second Hospital of Inner Mongolia Medical University, Inner Mongolia Huhehot 010030, China
  • Received:2017-03-11 Published:2020-12-01
  • Corresponding author: Jingjuan Wang
引用本文:

韩长旭, 张婷, 王婧娟, 孔令跃, 额尔顿图, 任逸众. 肩袖撕裂保守治疗的临床疗效观察[J/OL]. 中华关节外科杂志(电子版), 2020, 14(06): 752-755.

Changxu Han, Ting Zhang, Jingjuan Wang, Lingyue Kong, Eerduntu, Yizhong Ren. Clinical results of conservative treatment for rotator cuff tear[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(06): 752-755.

目的

评估肩峰下间隙注射长效激素、盂肱关节内注射玻璃酸钠结合物理疗的方法治疗肩袖损伤的临床疗效。

方法

选取2014年10月至2015年4月期间在内蒙古医科大学第二附属医院因肩袖撕裂接受保守治疗的患者,予以肩峰下间隙注射长效激素(复方倍他米松)+利多卡因、盂肱关节内注射玻璃酸钠,以及物理治疗方法,包括热疗、拉伸训练、主被动的关节活动度练习和肌肉力量练习。所有患者至少经过6个月的保守治疗,保守治疗前后使用美国加州大学肩关节功能评分(UCLA),肩关节功能评分(Constant),视觉模拟评分法(VAS),对保守治疗前及随访时的肩关节进行评估。保守治疗前和随访时数据采用配对t检验分析。

结果

共有75例患者经过14~20个月随访,患者的平均年龄(62±11)岁。40%的患者疼痛消失,30%的患者疼痛减轻不需要口服止疼药治疗。70%的患者的日常生活没有影响。保守治疗前UCLA评分(22.1±1.5)、Constant评分(59.2±5.9)、VAS评分(3.9±0.3),最后一次随访时UCLA评分(35.5±1.3)、Constant评分(87.4±1.3)、VAS评分(1.8±0.5),差异有统计学意义(t=-5.436、-8.935、-4.136,均为P<0.01)。

结论

肩峰下间隙注射长效激素、盂肱关节内注射玻璃酸钠结合物理疗治疗肩袖撕裂的方法对于早期肩袖全层撕裂的患者治疗效果较好。

Objective

To evaluate the clinical efficacy of conservative treatment for rotator cuff tear associated with mediation injection and physiotherapy.

Methods

The patients with full rotator cuff tear were given conservative treatment in the Second Affiliated Hospital of Inner Mongolia Medical University from October 2014 to April 2015. The subacromial spaces were injected with long-acting hormone (compound betamethasone) + lidocaine, and the glenohumeral joints were injected with sodium hyaluronate, combining with the physical therapy, such as hyperthermia, stretching, active and passive joint motions and muscle strength exercise. All the patients received conservative treatment for at least six months. Shoulder joint function score (Constant), University of California at Los Angeles shoulder rating scale (UCLA)and visual analogue scale (VAS) were used before and after conservative treatment to evaluate the shoulder joint before and during follow-up. Paired t test was used to analyze the data before and during conservative treatment.

Results

A total of 75 patients were followed up for 14 to 20 months. The mean age of the patients was (62±11) years. Among the patients, 40% had no pain relief and 30% did not require oral pain medication. Seventy percent of the patients had no impact on their daily lives. Before conservative treatment, UCLA score (22.1±1.5), Constant score (59.2±5.9), VAS score (3.9±0.3), and UCLA score (35.5±1.3), Constant score (87.4±1.3), and VAS score (1.8±0.5) at the last follow-up showed statistically significant differences (t=-5.436, -8.935, -4.136, all P<0.01).

Conclusion

The subacromial spaces injection of long-acting hormone + lidocaine and the glenohumeral joints injection with sodium hyaluronate combining with the physical therapy may have good clinical effects for rotator cuff tear.

图2 X标记为喙突外上1 cm或者外下1 cm,盂肱关节的注射位置
表1 肩袖撕裂患者保守治疗前后UCLA、Constant、VAS评分比较(±s)
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