Bateman Marcus, McClymont Stuart, Hinchliffe Sally R
Derby Hospitals NHS Foundation Trust, Physiotherapy Department, Level 3, London Road Community Hospital, London Road, Derby, DE1 2QY, UK,
Clin Rheumatol. 2014 Jul;33(7):1005-8. doi: 10.1007/s10067-014-2501-x. Epub 2014 Feb 2.
Frozen shoulder is a common condition resulting in pain, stiffness and functional impairment. Symptoms can persist for months or even years if left untreated. Various treatments are available, but a standard care package does not exist and the most cost-effective treatment has not been established. The objective of this study was to conduct a service evaluation of current practice to establish the effectiveness of corticosteroid injection and physiotherapy intervention and the costs associated. A review of all patients with a diagnosis of frozen shoulder who had received a corticosteroid injection and physiotherapy was undertaken for a 12-month period at a single NHS hospital in the UK. Patient-reported outcome measures were analysed and the costs for treatment calculated. Out of the 55 patients, 43 were happy to be discharged following treatment. Ten were referred for a surgical opinion and two were lost to follow-up. The median pain rating significantly reduced from 8 (interquartile range (IQR) 7, 9) to 2 (IQR 0, 3.75) (p < 0.001). Of the patients, 62 % reported a greater than 60 % improvement. On average, patients attended for an initial consultation and four follow-up sessions at a total cost to the NHS of £135. Based on this small service evaluation study, corticosteroid injection administered by an experienced physiotherapist with follow-up physiotherapy appears to be an effective treatment for frozen shoulder.
肩周炎是一种常见病症，会导致疼痛、僵硬和功能障碍。如果不进行治疗，症状可能会持续数月甚至数年。目前有多种治疗方法，但尚无标准的护理方案，且最具成本效益的治疗方法也尚未确定。本研究的目的是对当前的治疗实践进行服务评估，以确定皮质类固醇注射和物理治疗干预的有效性以及相关成本。在英国一家国民保健服务（NHS）医院，对所有诊断为肩周炎且接受过皮质类固醇注射和物理治疗的患者进行了为期12个月的回顾。分析了患者报告的结局指标并计算了治疗成本。55名患者中，43名在治疗后乐意出院。10名患者被转诊以寻求手术意见，2名患者失访。疼痛评分中位数从8（四分位间距（IQR）7, 9）显著降至2（IQR 0, 3.75）（p < 0.001）。62%的患者报告改善超过60%。患者平均接受了一次初诊和四次随访，NHS的总成本为135英镑。基于这项小型服务评估研究，由经验丰富的物理治疗师进行皮质类固醇注射并辅以物理治疗随访，似乎是治疗肩周炎的有效方法。
