Haghighat Shila, Taheri Parisa, Banimehdi Mohsen, Taghavi Arash
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Glob J Health Sci. 2015 Nov 18;8(7):179-84. doi: 10.5539/gjhs.v8n7p179.
Local steroid injections are common for treatment of impingement syndrome. Corticosteroid injections methods are basically in two formats, blind or with image guidance. The aim of this study is to compare the effect of ultrasound-guided in comparison with blind corticosteroid injections in patients with impingement syndrome. This study is a randomized clinical trial study undertaken in patients with diagnosis of impingement syndrome done in Isfahan University of Medical Science clinics from February 2014 to February 2015. The number of all patients registered in the study is 48; and then 40 patients were allocated to either control group randomly which received blind steroid injection or case group that underwent ultrasound-guided steroid injection. The clinical symptoms were assessed using Shoulder Pain and Disability Index (SPADI) questionnaire, Visual Analogue Scale (VAS) and shoulder range of motion (ROM) using goniometer at baseline and six weeks after the injection. Data analysis revealed a significant difference in the mean of the VAS, SPADI and shoulder ROM in both groups 6 weeks after intervention (P < 0.05). Patients with ultrasound guided corticosteroid injection had statistically significant improvements in function and shoulder ROM (abduction, flexion) compared to blind injection group after 6 weeks (P<0.05). There was not significant differences in pain (VAS) and internal and external rotation between these two groups (p>0.05). Our findings suggest that US image guided can improve the shoulder function of patients with impingement syndrome, and thus can be considered in comprehensive care programs of these patients for fast speed of rehabilitation.
局部类固醇注射是治疗撞击综合征的常用方法。皮质类固醇注射方法基本有两种形式,即盲注或影像引导注射。本研究的目的是比较超声引导下与盲法皮质类固醇注射对撞击综合征患者的治疗效果。本研究是一项随机临床试验研究,于2014年2月至2015年2月在伊斯法罕医科大学诊所对诊断为撞击综合征的患者进行。该研究中登记的所有患者人数为48名;然后将40名患者随机分配到接受盲法类固醇注射的对照组或接受超声引导类固醇注射的病例组。在基线时以及注射后六周,使用肩痛和功能障碍指数(SPADI)问卷、视觉模拟量表(VAS)以及用角度计测量的肩关节活动范围(ROM)来评估临床症状。数据分析显示,干预六周后两组的VAS、SPADI和肩关节ROM平均值存在显著差异(P<0.05)。与盲注组相比,超声引导下皮质类固醇注射的患者在六周后功能和肩关节ROM(外展、屈曲)方面有统计学上的显著改善(P<0.05)。两组在疼痛(VAS)以及内旋和外旋方面没有显著差异(p>0.05)。我们的研究结果表明,超声影像引导可以改善撞击综合征患者的肩部功能,因此在这些患者的综合护理方案中,鉴于其康复速度快,可以考虑采用。