中国骨与关节外科
中國骨與關節外科
중국골여관절외과
CHINESE BONE AND JOINT SURGERY
2014年
3期
193-196
,共4页
喻飞%刁乃成%杨波%李强
喻飛%刁迺成%楊波%李彊
유비%조내성%양파%리강
冻结肩%关节镜%关节囊松解
凍結肩%關節鏡%關節囊鬆解
동결견%관절경%관절낭송해
fshoulder joint%frozen shoulder%arthroscope%articular capsule release
背景：冻结肩是临床常见疾病，治疗方法较多，大部分患者可以通过保守治疗治愈。而对于保守治疗无效的患者，目前有文献报道应用关节镜下松解结合麻醉下手法松解治疗，效果满意。目的：通过术前和术后肩关节活动度及疼痛程度的变化来评估关节镜松解术结合麻醉下手法松解治疗冻结肩的效果。方法：回顾性分析2011年1月至2013年12月接受关节镜松解术结合麻醉下手法松解治疗的21例冻结肩患者的病例资料。年龄48~67岁，平均55.85岁；男6例，女15例；左侧14例，右侧7例；原发性12例，继发性9例。所有患者均经6~18个月，平均11.23个月的保守治疗无效后行关节镜松解术结合麻醉下手法松解。结果：全部获得随访，随访时间为7~32个月，平均15.57个月。被动前屈、外展、外旋活动度由术前平均86.0°±10.8°，47.4°±7.5°，4.3°±7.8°提升至术后平均142.1°±11.8°，92.6°±12.1°，57.6°±19.8°（P＜0.001）。Constant-Murley肩关节功能评分从术前平均（12.9±2.1）分提高至术后平均（26.2±2.4）分。所有患者术后肩关节疼痛均有不同程度减轻。VAS评分由术前平均（7.4±1.1）分降至术后平均（2.5±1.0）分（P＜0.001）。结论：关节镜松解术结合麻醉下手法松解是治疗冻结肩的有效手段。
揹景：凍結肩是臨床常見疾病，治療方法較多，大部分患者可以通過保守治療治愈。而對于保守治療無效的患者，目前有文獻報道應用關節鏡下鬆解結閤痳醉下手法鬆解治療，效果滿意。目的：通過術前和術後肩關節活動度及疼痛程度的變化來評估關節鏡鬆解術結閤痳醉下手法鬆解治療凍結肩的效果。方法：迴顧性分析2011年1月至2013年12月接受關節鏡鬆解術結閤痳醉下手法鬆解治療的21例凍結肩患者的病例資料。年齡48~67歲，平均55.85歲；男6例，女15例；左側14例，右側7例；原髮性12例，繼髮性9例。所有患者均經6~18箇月，平均11.23箇月的保守治療無效後行關節鏡鬆解術結閤痳醉下手法鬆解。結果：全部穫得隨訪，隨訪時間為7~32箇月，平均15.57箇月。被動前屈、外展、外鏇活動度由術前平均86.0°±10.8°，47.4°±7.5°，4.3°±7.8°提升至術後平均142.1°±11.8°，92.6°±12.1°，57.6°±19.8°（P＜0.001）。Constant-Murley肩關節功能評分從術前平均（12.9±2.1）分提高至術後平均（26.2±2.4）分。所有患者術後肩關節疼痛均有不同程度減輕。VAS評分由術前平均（7.4±1.1）分降至術後平均（2.5±1.0）分（P＜0.001）。結論：關節鏡鬆解術結閤痳醉下手法鬆解是治療凍結肩的有效手段。
배경：동결견시림상상견질병，치료방법교다，대부분환자가이통과보수치료치유。이대우보수치료무효적환자，목전유문헌보도응용관절경하송해결합마취하수법송해치료，효과만의。목적：통과술전화술후견관절활동도급동통정도적변화래평고관절경송해술결합마취하수법송해치료동결견적효과。방법：회고성분석2011년1월지2013년12월접수관절경송해술결합마취하수법송해치료적21례동결견환자적병례자료。년령48~67세，평균55.85세；남6례，녀15례；좌측14례，우측7례；원발성12례，계발성9례。소유환자균경6~18개월，평균11.23개월적보수치료무효후행관절경송해술결합마취하수법송해。결과：전부획득수방，수방시간위7~32개월，평균15.57개월。피동전굴、외전、외선활동도유술전평균86.0°±10.8°，47.4°±7.5°，4.3°±7.8°제승지술후평균142.1°±11.8°，92.6°±12.1°，57.6°±19.8°（P＜0.001）。Constant-Murley견관절공능평분종술전평균（12.9±2.1）분제고지술후평균（26.2±2.4）분。소유환자술후견관절동통균유불동정도감경。VAS평분유술전평균（7.4±1.1）분강지술후평균（2.5±1.0）분（P＜0.001）。결론：관절경송해술결합마취하수법송해시치료동결견적유효수단。
Background:Frozen shoulder is a common disorder, which is described as a self-limiting condition with spontaneous ten-dency to recover. To those patients in whom conservative treatment is failed, arthroscopic treatment combined with manipu-lation has been proven to be effective. Objective: To assess the changes of should joint range of motion and pain and investigate the clinical efficacy of frozen shoulder treated by arthroscopy and painless manipulation. Methods:Twenty one patients who underwent arthroscopic capsular release and painless manipulation for frozen shoulder between January 2011 and December 2013 were enrolled in the retrospective study. There were 6 males and 15 females with a mean age of 55.85 years (range;48 to 67 years). The left shoulder was involved in 14 cases and the right was involved in 7 cases. Of them, 12 patients suffered from primary disease and 9 with secondary disease. Arthroscopic capsular release and painless manipulation was performed in all patients after a mean of 11.23 months of physical therapy (range, 6 to 18 months). Results:The mean duration of follow-up was 15.57 months (range, 7 to 32 months). The mean ROM of forward flexion, ab-duction, external rotation were significantly increased postoperatively as compared with preoperative ones (86.0°±10.8° vs. 142.1°±11.8°, 47.4°±7.5° vs. 92.6°±12.1°, 4.3°±7.8° vs. 57.6°±19.8°, P<0.001). Preoperative Constant-Murley functional score was 12.9±2.1 and postoperative one was 26.2±2.4. Shoulder pain relieved to some extent. VAS score decreased from 7.4±1.1 (preoperative mean) to 2.5±1.0 (postoperative mean, P<0.001). Conclusions: Arthroscopic capsule release and painless manipulation is an effective method for the treatment of frozen shoulder.
