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肩胛上神经阻滞在特发性冻结肩治疗中的作用:一项临床试验调查。

Role of suprascapular nerve block in idiopathic frozen shoulder treatment: a clinical trial survey.

作者信息

Mardani-Kivi Mohsen, Nabi Bahram Naderi, Mousavi Mir-Hashem, Shirangi Ardeshir, Leili Ehsan Kazemnejad, Ghadim-Limudahi Zahra Haghparast

机构信息

Orthopaedic Research Center, Department of Orthopaedic, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Anesthesiology Research Center, Department of Anesthesiology, Alzahra Hospital, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

Clin Shoulder Elb. 2022 Jun;25(2):129-139. doi: 10.5397/cise.2021.00661. Epub 2022 May 16.

Abstract

BACKGROUND

Several therapeutic methods have been proposed for frozen shoulder syndrome. These include suprascapular nerve block, a simple and cost-effective technique that eliminates the need for nonsteroidal anti-inflammatory drug therapy.

METHODS

This was a clinical trial that included patients with unilateral shoulder joint stiffness. Patients were divided into three groups: those treated with isolated physiotherapy for 12 weeks (PT group), those treated with a single dose intra-articular injection of corticosteroid together with physiotherapy (IACI group), and those treated with a suprascapular nerve block performed with a single indirect injection of 8-mL lidocaine HCL 1% and 2 mL (80 mg) methylprednisolone acetate together with physiotherapy (SSNB group). The variables assessed were age, sex, side of involvement, dominant limb, presence of diabetes, physical examination findings including erythema, swelling, and muscle wasting; palpation and movement findings; shoulder pain and disability index (SPADI) score; and the visual analog scale (VAS) score pre-intervention and at 2-, 4-, 6-, and 12-week post-intervention.

RESULTS

Ninety-seven patients were included in this survey (34 cases in the PT group, 32 cases in the IACI group, and 31 cases in the SSNB group). Mean age was 48.55±11.06 years. Fifty-seven cases were female (58.8%) and 40 were male (41.2%). Sixty-eight patients had a history of diabetes (70.1%). VAS and SPADI scores and range of mototion degrees dramatically improved in all cases (p<0.001). Results were best in the SSNB group (p<0.001), and the IACI group showed better results than the PT group (p<0.001).

CONCLUSIONS

Suprascapular nerve block is an effective therapy with long-term pain relief and increased mobility of the shoulder joint in patients with adhesive capsulitis.

摘要

背景

针对肩周炎综合征已提出多种治疗方法。其中包括肩胛上神经阻滞,这是一种简单且经济有效的技术,无需使用非甾体抗炎药治疗。

方法

这是一项临床试验,纳入单侧肩关节僵硬的患者。患者分为三组:接受为期12周的单纯物理治疗的患者(PT组)、接受单次关节内注射皮质类固醇并联合物理治疗的患者(IACI组)、接受单次间接注射8毫升1%盐酸利多卡因和2毫升(80毫克)醋酸甲泼尼龙并联合物理治疗的肩胛上神经阻滞的患者(SSNB组)。评估的变量包括年龄、性别、受累侧、优势肢体、是否患有糖尿病、体格检查结果(包括红斑、肿胀和肌肉萎缩);触诊和活动结果;肩关节疼痛和功能障碍指数(SPADI)评分;以及干预前和干预后2周、4周、6周和12周的视觉模拟量表(VAS)评分。

结果

本研究共纳入97例患者(PT组34例,IACI组32例,SSNB组31例)。平均年龄为48.55±11.06岁。57例为女性(58.8%),40例为男性(41.2%)。68例患者有糖尿病史(70.1%)。所有病例的VAS和SPADI评分以及活动度均显著改善(p<0.001)。SSNB组效果最佳(p<0.001),IACI组的效果优于PT组(p<0.001)。

结论

肩胛上神经阻滞是一种有效的治疗方法,可长期缓解粘连性肩周炎患者的疼痛并增加肩关节活动度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e93f/9185110/03fc583cc9ad/cise-2021-00661f1.jpg

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