[超声引导下微创伤治疗急性肩峰下滑囊炎的病例对照研究]
[Case control study on ultrasound guided microtraumatic treatment of acute subacromial bursitis].
作者信息
Duan Huan, Pu Dan, Chen Shi-Yin
机构信息
Department of TCM Orthopaedics, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China.
Department of TCM Orthopaedics, Sichuan Provincial People's Hospital, Chengdu 610072, Sichuan, China;
出版信息
Zhongguo Gu Shang. 2016 Sep 25;29(9):800-803. doi: 10.3969/j.issn.1003-0034.2016.09.006.
OBJECTIVE
To evaluate the efficacy of ultrasound guided microtraumatic treatment of acute subacromial bursitis.
METHODS
The patients with shoulder pain from June 2012 to March 2014 were treated with musculoskeletal bone ultrasound examination. A total of 120 patients were diagnosed with acute subacromial bursitis, who were randomized divided into two groups:US guided injection group(ultrasound group) and palpation guided injection group(closed group). The patients in each group were injected with a mixture of 3.5 ml Betamethasone compound lidocaine mixture and 2.5 ml Sodium hyaluronate into the subacromial bursa. The outcome measures were the visual analog scale(VAS) for analyzing pain degree, the night rest pain and Constant-Murley score for detecting shoulder function, rate of secondary injection, and comprehensive effect. The VAS, the night rest pain and CMS were evaluated before, 1 day, 1 week, and 1 month after the injection.
RESULTS
After treatment, the shoulder pain and function were improved. One day and 1 week after the injection, the VAS between the two groups were compared. The pain improvement in ultrasonic group was better than in the traditional group, and the difference was statistically significant(<0.05). In the two groups, the night rest pain was relieved after treatment, and 1 day after the injection, the night rest pain in the ultrasonic group was significantly lower than that in the traditional group(<0.05). One day, 1 week and 1 mouth after the injection, the CMS between the two groups were compared, and the improvement of CMS in the ultrasonic group was significantly better than that in the traditional group(<0.05). The patient number with secondary injection in the ultrasonic group was 13 cases, which was significantly less than that in the closed group 45 cases(<0.05). The recovery number of ultrasonic group was significantly better than that of the traditional group(<0.05).
CONCLUSIONS
The ultrasound guided microtraumatic treatment of acute subacromial bursitis worked faster than traditional closed therapy. The short term curative effect and the comprehensive curative effect is better than the traditional closed treatment. The US guided subacromial injection technique is effective in guiding the needle into the subacromial bursa in patients with acute subacromial bursitis.
目的
评估超声引导下微创伤治疗急性肩峰下滑囊炎的疗效。
方法
对2012年6月至2014年3月肩部疼痛患者进行肌肉骨骼超声检查。共120例诊断为急性肩峰下滑囊炎的患者，随机分为两组：超声引导注射组（超声组）和触诊引导注射组（封闭组）。每组患者均在肩峰下滑囊内注射3.5 ml复方倍他米松利多卡因混合液和2.5 ml透明质酸钠混合液。观察指标包括用于分析疼痛程度的视觉模拟评分（VAS）、夜间静息痛以及用于检测肩部功能的Constant-Murley评分、二次注射率和综合疗效。在注射前、注射后1天、1周和1个月对VAS、夜间静息痛和CMS进行评估。
结果
治疗后，肩部疼痛和功能均有改善。注射后1天和1周，比较两组的VAS。超声组的疼痛改善情况优于传统组，差异有统计学意义（<0.05）。两组治疗后夜间静息痛均减轻，注射后1天，超声组的夜间静息痛明显低于传统组（<0.05）。注射后1天、1周和1个月，比较两组的CMS，超声组CMS的改善情况明显优于传统组（<0.05）。超声组二次注射的患者有13例，明显少于封闭组的45例（<0.05）。超声组的恢复情况明显优于传统组（<0.05）。
结论
超声引导下微创伤治疗急性肩峰下滑囊炎起效比传统封闭治疗更快。短期疗效和综合疗效均优于传统封闭治疗。超声引导下肩峰下注射技术能有效引导针进入急性肩峰下滑囊炎患者的肩峰下滑囊。
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