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乳腺癌术后粘连性肩周炎患者糖皮质激素注射水扩张术的效果及生物力学特性

Effects of Hydrodilatation With Corticosteroid Injection and Biomechanical Properties in Patients With Adhesive Capsulitis After Breast Cancer Surgery.

作者信息

Lee Chang Won, Kim In Soo, Kim Jeong-Gil, Hwang Hyeoncheol, Jung Il Young, Lee Shi-Uk, Seo Kwan-Sik

机构信息

Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea.

Department of Rehabilitation medicine, Seosong Hospital, Incheon, Korea.

出版信息

Ann Rehabil Med. 2022 Aug;46(4):192-201. doi: 10.5535/arm.22059. Epub 2022 Aug 31.

Abstract

OBJECTIVE

To compare the biomechanical properties of the glenohumeral joint capsule between adhesive capsulitis (AC) after breast cancer surgery and idiopathic AC and demonstrate the effects of hydrodilatation (HD) with corticosteroid injection for AC after breast cancer surgery.

METHODS

Twenty-three prospective patients with AC after breast cancer surgery (BC group) and 44 retrospective patients with idiopathic AC without breast cancer (CON group) underwent HD with corticosteroid injection and home exercise training. We compared their biomechanical characteristics (capsular capacity, maximal pressure, and capsular stiffness). In the BC group, the passive range of motion (ROM) of the affected shoulder and a questionnaire (Shoulder Pain and Disability Index [SPADI]) were evaluated at baseline and 2 and 4 weeks after treatment.

RESULTS

The BC group showed higher biomechanical characteristics (maximal pressure and capsular stiffness) than did the CON group. The mean maximal pressure and capsular stiffness were 519.67±120.90 mmHg and 19.69±10.58 mmHg/mL in the BC group and 424.78±104.42 mmHg and 11.55±7.77 mmHg/mL in the CON group (p=0.002 and p=0.001, respectively). And, the BC group showed significant improvements in all ROMs (abduction, flexion, and external rotation) and the SPADI pain and disability sub-scores following the treatment.

CONCLUSION

The glenohumeral joint capsular stiffness was greater in the patients with AC after breast cancer surgery than in those with idiopathic AC. HD with corticosteroid injection was effective in treating AC after breast cancer surgery.

摘要

目的

比较乳腺癌术后粘连性关节囊炎(AC)与特发性AC患者的盂肱关节囊生物力学特性,并证明乳腺癌术后AC采用皮质类固醇注射水扩张术(HD)的效果。

方法

23例乳腺癌术后AC的前瞻性患者(BC组)和44例无乳腺癌的特发性AC回顾性患者(CON组)接受了皮质类固醇注射HD及家庭锻炼训练。我们比较了他们的生物力学特征(关节囊容量、最大压力和关节囊刚度)。在BC组中,在基线以及治疗后2周和4周评估患侧肩部的被动活动范围(ROM)和一份问卷(肩痛和功能障碍指数[SPADI])。

结果

BC组的生物力学特征(最大压力和关节囊刚度)高于CON组。BC组的平均最大压力和关节囊刚度分别为519.67±120.90 mmHg和19.69±10.58 mmHg/mL,CON组为424.78±104.42 mmHg和11.55±7.77 mmHg/mL(分别为p = 0.002和p = 0.001)。并且,BC组在治疗后的所有ROM(外展、屈曲和外旋)以及SPADI疼痛和功能障碍子评分方面均有显著改善。

结论

乳腺癌术后AC患者的盂肱关节囊刚度大于特发性AC患者。皮质类固醇注射HD对治疗乳腺癌术后AC有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56d0/9452287/4baf90dd9ab3/arm-22059f1.jpg

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