CAJ | 학술논문

背景:应用玻璃酸钠关节腔内注射联合类固醇激素类药物行神经阻滞在膝关节骨性关节炎患者中获得了非常满意的临床效果,联合治疗对肩周炎的治疗效果如何?目的:探讨玻璃酸钠肩关节腔内注射结合倍他米松行神经及痛点阻滞改善肩周炎患者疼痛变化及关节功能.设计:自身前后对照实验.单位:首都医科大学附属北京天坛医院.对象:纳入首都医科大学附属北京天坛医院疼痛门诊2004-01/10就诊的肩周炎患者20例,年龄40～65岁.方法:对20例肩周炎患者行肩关节腔内注射玻璃酸钠与倍他米松行神经及痛点阻滞联合治疗,于治疗前和治疗后1周时记录.①疼痛症状:采用目测类比评分,以"没有任何疼痛感觉"为0分,"设想的不能忍受的疼痛"为10分,记录安静时、运动时疼痛评分.②日常生活活动的评分:按5级法记录,4分为全部做不到;3分经他人帮助可以做到;2分自己勉强可以做到,多半感到不便;1分自己勉强可以做到,不太感到不便;0分与正常人一样可以做到.主要观察指标:①肩周炎患者安静和运动时疼痛评分.②日常生活活动评分.结果:按实际处理分析,20例患者均进入结果分析.①安静时目测类比评分:治疗1周后低于治疗前[(4.34±1.33),(8.27±1.37)分,P＜0.01].②运动时目测类比评分:治疗1周后低于治疗前[(4.73±1.31),(8.49±1.35)分,P＜0.01].③日常生活动作评分:治疗1周后低于治疗前[(1.10±0.74),(3.30±0.48)分,P＜0.01].结论:肩关节腔内注射玻璃酸钠结合倍他米松行神经及痛点阻滞可有效治疗肩周炎,且无明显不良反应发生,值得在疼痛治疗中推广应用.
배경:응용파리산납관절강내주사연합류고순격소류약물행신경조체재슬관절골성관절염환자중획득료비상만의적림상효과,연합치료대견주염적치료효과여하?목적:탐토파리산납견관절강내주사결합배타미송행신경급통점조체개선견주염환자동통변화급관절공능.설계:자신전후대조실험.단위:수도의과대학부속북경천단의원.대상:납입수도의과대학부속북경천단의원동통문진2004-01/10취진적견주염환자20례,년령40～65세.방법:대20례견주염환자행견관절강내주사파리산납여배타미송행신경급통점조체연합치료,우치료전화치료후1주시기록.①동통증상:채용목측류비평분,이"몰유임하동통감각"위0분,"설상적불능인수적동통"위10분,기록안정시、운동시동통평분.②일상생활활동적평분:안5급법기록,4분위전부주불도;3분경타인방조가이주도;2분자기면강가이주도,다반감도불편;1분자기면강가이주도,불태감도불편;0분여정상인일양가이주도.주요관찰지표:①견주염환자안정화운동시동통평분.②일상생활활동평분.결과:안실제처리분석,20례환자균진입결과분석.①안정시목측류비평분:치료1주후저우치료전[(4.34±1.33),(8.27±1.37)분,P＜0.01].②운동시목측류비평분:치료1주후저우치료전[(4.73±1.31),(8.49±1.35)분,P＜0.01].③일상생활동작평분:치료1주후저우치료전[(1.10±0.74),(3.30±0.48)분,P＜0.01].결론:견관절강내주사파리산납결합배타미송행신경급통점조체가유효치료견주염,차무명현불량반응발생,치득재동통치료중추엄응용.
BACKGROUND: Very satisfactory clinical effects have been achieved in treatment of osteoarthritis of knee with intraarticular injection of sodium hyaluronate (SH) allied with steroid hormones for nerve block. How will such allied treatment be used for periarthritis of shoulder?OBJECTIVE: To probe into the improvement of pain and joint function in periarthritis of shoulder treated with integration of intraarticular injection of SH with nerve and pain block with betamethasone.DESIGN: Self-control was designed before and after experiment.SETTING: Beijing Tiantan Hospital, Capital University of Medical Sciences PARTICIPANTS: Twenty patients with periarthritis of shoulder were included, aged from 40 to 65 years from Pain Clinic of Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences from January to October 2004.METHODS: Integration of intraarticular injection of SH with nerve and pain block with betamethasone was applied to treat 20 cases of periarthritis of shoulder and the record was done before treatment and 1in which, "no any pain sensation" was 0 score, "unable to bear pain with imagination" was 10 scores. Pain score was recorded during quiet involved. 4 scores indicated being impossible completely, 3 scores indicate being possible with help, 2 scores indicate being possibled reluctantly and mostly feeling inconvenient, 1 score indicated being possible reluctantly without inconvenience and 0 score indicated being possible as healthy person.of daily life activity.RESULTS: According to practical management and analysis, 20 cases enment compared with that before treatment [(4.34±1.33),(8.27±1.37)scores,compared with that before treatment [(4.73±1.31), (8.49±1.35)scores,ment compared with that before treatment [ ( 1.10 ±0.74), (3.30 ±0.48 )scores, P ＜ 0.01]. CONCLUSION: Integration of intraarticular injection of SH with nerve and pain block with betamethasone treats effectively periarthritis of shoulder, without remarkably harmful reaction and it is worth in popularization in treatment of pain.