全身麻醉下手法松解治疗重症肩周炎临床效果研究(1)
摘要：目的 观察全身麻醉下行手法松解治疗重症肩周炎的临床效果。方法 选取自2014年10月～2015年3月我院骨伤科门诊原发性重症肩周炎患者55例，分为口服药物治疗组(D组)、局部注射治疗组(I组)和全麻手法松解组(A组)。其中D组以非甾体镇痛药为主的口服药物治疗；I组予以0.5%利多卡因20 ml与得宝松(复方倍他米松)1 ml/7 mg组成的消炎镇痛液痛点注射；A组予以全身麻醉下手法松解术。疗程结束后2 w评价疗效、VAS和不良发应发生率。结果 A组患者术后2 w治愈率优于其他两组(P<0.05)；有效率与I组没有差异(P>0.05)，两组均高于D组(P<0.05)。VAS在A组明显低于其他两组(P<0.05)。三组间不良反应没有统计学差异，其中A组患者未发现有不良反应，其他两组分别为2例与1例。结论 对于重症肩周炎患者全麻下实施手法松解术优于口服药物治疗和局部注射治疗。
关键词：肩关节周围炎；手法松解；全身麻醉
中图分类号：R684 文献标识码：A 文章编号：1006-1959(2017)16-0058-02
, 百拇医药
Clinical Effect of Manipulation Loosening on the Treatment of Severe Scapulohumeral Periarthritis under General Anesthesia
ZHANG Dong-sheng
(Department of Orthopaedics and Traumatology，Jizhou District Hospital of Tianjin City，Tianjin 301900，China)
Abstract：Objective To observe the clinical effect of general anesthesia manipulation therapy for severe scapulohumeral periarthritis.Methods From October 2014 to March 2015 in our hospital outpatient primary severe periarthritis patients 55 cases，divided into oral drug treatment group(D group)， local injection treatment group(I group)and general anesthesia manipulation group(A group).Oral drug group D with non steroidal anti-inflammatory drugs treatment； group I received 0.5% lidocaine 20 ml and Diprospan(compound betamethasone)1 ml/7 mg composed of analgesic pain point injection；group A received general anesthesia maneuver release under the condition of operation.The curative effect，VAS and adverse reaction rate were evaluated two weeks after the end of treatment.Results The cure rate of A group was better than that of the other two groups(P<0.05)2 w after operation；the effective rate was not different from that in group I(P>0.05)，and the two groups were higher than those in group D(P<0.05).VAS was significantly lower in group A than in the other two groups(P<0.05).There was no statistical difference in adverse reactions between the three groups， and no adverse reactions were found in the A group.The other two groups were 2 cases and 1 cases respectively.Conclusion For severe frozen shoulder patients，manual loosening under general anesthesia is superior to oral medication and local injection therapy.
Key words：Periarthritis of shoulder；Manipulation loosening；General anesthesia
肩關节周围炎，简称肩周炎，俗称“冻结肩”“五十肩”，是一种严重影响患者的生活工作的良性疾病。尽管肩周炎具有自愈倾向，但患病期间常难以忍受，尤其是重症肩周炎，不仅疼痛剧烈，而且严重损害肩关节功能。肩周炎常规疗法(口服药物、痛点注射或神经阻滞等)对重症肩周炎效果不佳。我科自2014年10月～2015年3月对门诊重度晚期肩关节周围炎(以下简称“重症肩周炎”)患者行全身麻醉(以下简称“全麻”)下无痛手法松解术，取得较好效果，现报告如下。, 百拇医药(张东升)
关键词：肩关节周围炎；手法松解；全身麻醉
中图分类号：R684 文献标识码：A 文章编号：1006-1959(2017)16-0058-02
, 百拇医药
Clinical Effect of Manipulation Loosening on the Treatment of Severe Scapulohumeral Periarthritis under General Anesthesia
ZHANG Dong-sheng
(Department of Orthopaedics and Traumatology，Jizhou District Hospital of Tianjin City，Tianjin 301900，China)
Abstract：Objective To observe the clinical effect of general anesthesia manipulation therapy for severe scapulohumeral periarthritis.Methods From October 2014 to March 2015 in our hospital outpatient primary severe periarthritis patients 55 cases，divided into oral drug treatment group(D group)， local injection treatment group(I group)and general anesthesia manipulation group(A group).Oral drug group D with non steroidal anti-inflammatory drugs treatment； group I received 0.5% lidocaine 20 ml and Diprospan(compound betamethasone)1 ml/7 mg composed of analgesic pain point injection；group A received general anesthesia maneuver release under the condition of operation.The curative effect，VAS and adverse reaction rate were evaluated two weeks after the end of treatment.Results The cure rate of A group was better than that of the other two groups(P<0.05)2 w after operation；the effective rate was not different from that in group I(P>0.05)，and the two groups were higher than those in group D(P<0.05).VAS was significantly lower in group A than in the other two groups(P<0.05).There was no statistical difference in adverse reactions between the three groups， and no adverse reactions were found in the A group.The other two groups were 2 cases and 1 cases respectively.Conclusion For severe frozen shoulder patients，manual loosening under general anesthesia is superior to oral medication and local injection therapy.
Key words：Periarthritis of shoulder；Manipulation loosening；General anesthesia
肩關节周围炎，简称肩周炎，俗称“冻结肩”“五十肩”，是一种严重影响患者的生活工作的良性疾病。尽管肩周炎具有自愈倾向，但患病期间常难以忍受，尤其是重症肩周炎，不仅疼痛剧烈，而且严重损害肩关节功能。肩周炎常规疗法(口服药物、痛点注射或神经阻滞等)对重症肩周炎效果不佳。我科自2014年10月～2015年3月对门诊重度晚期肩关节周围炎(以下简称“重症肩周炎”)患者行全身麻醉(以下简称“全麻”)下无痛手法松解术，取得较好效果，现报告如下。, 百拇医药(张东升)
参见：首页 > 医疗版 > 疾病专题 > 骨科 > 腰痛及颈肩痛 > 肩周炎