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基层医疗中的急性肩痛——一项观察性研究。

Acute shoulder pain in primary care - an observational study.

作者信息

Masters Scott, O'Doherty Lorna, Mitchell Geoffrey K, Yelland Michael

机构信息

University of Otago, New Zealand.

出版信息

Aust Fam Physician. 2007 Jun;36(6):473-6.

Abstract

BACKGROUND

Shoulder pain is a common presentation in general practice. Data on prognosis, treatment and compliance for acute shoulder pain are lacking but would be valuable for guiding decision making. This study collected data on acute shoulder pain and its outcome over 6 months.

METHODS

A prospective observational study of 100 acute shoulder pain patients from 21 general practices in southeast Queensland.

RESULTS

Disability levels at presentation were the best predictor of outcome at 6 months. Patients who had not fully recovered at 6 months had higher risk of depression at presentation. The biggest improvements in pain and disability scores occurred in the first month of management, with almost 60% of patients fully recovered at 6 months. Over 40% of patients had at least one radiological investigation for their pain.

DISCUSSION

Measuring disability, pain and mood levels in acute shoulder pain patients gives the best prognostic data. The use of radiological investigations may be higher than is clinically necessary. Early multimodal management of acute shoulder pain patients needs consideration.

摘要

背景

肩痛是全科医疗中常见的症状。目前缺乏关于急性肩痛的预后、治疗及依从性的数据,但这些数据对于指导决策很有价值。本研究收集了急性肩痛及其6个月预后的数据。

方法

对昆士兰州东南部21家全科诊所的100例急性肩痛患者进行前瞻性观察研究。

结果

就诊时的残疾程度是6个月预后的最佳预测指标。6个月时未完全康复的患者就诊时患抑郁症的风险更高。疼痛和残疾评分的最大改善出现在治疗的第一个月,近60%的患者在6个月时完全康复。超过40%的患者因疼痛至少接受了一次影像学检查。

讨论

测量急性肩痛患者的残疾、疼痛和情绪水平可提供最佳的预后数据。影像学检查的使用可能高于临床必要水平。需要考虑对急性肩痛患者进行早期多模式管理。

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