超声引导肩胛上神经阻滞联合盂肱关节类固醇注射治疗粘连性肩关节囊炎

目的观察超声引导肩胛上神经阻滞联合盂肱关节类固醇注射治疗粘连性肩关节囊炎效果。方法将60例粘连性肩关节囊炎患者随机均分为研究组和对照组。对研究组在常规康复治疗基础上予超声引导肩胛上神经阻滞联合盂肱关节类固醇注射,对照组给予常规康复治疗。于治疗前、治疗2周和4周后评估视觉模拟评分(VAS)、Constant肩关节评分(CSS)和肩部活动范围。结果研究组治疗2周和4周后VAS和CSS较治疗前降低(P均0.01),且均低于对照组同期(P均0.01);2周和4周后肩部前屈、外展、内旋和外旋活动范围均较治疗前增加(P均0.01),且除治疗2周后外旋活动范围外均优于对照组(P均0.01)。治疗后3、6个月,研究组疼痛症状复发率均低于对照组(P均0.05)。结论超声引导肩胛上神经阻滞联合盂肱关节类固醇注射可提高粘连性肩关节囊炎康复治疗效果,减少复发。

Ultrasound-guided suprascapular nerve block combined with glenohumeral steroid injection for treatment of adhesive shoulder capsulitis

Objective To observe the effect of ultrasound-guided suprascapular nerve block combined with steroid injection of glenohumeral joint for treatment of adhesive shoulder capsular inflammation. Methods Totally 60 patients with adhesive shoulder capsulitis were randomly assigned into research group and control group (each n=30). Patients in research group received ultrasound-guided suprascapular nerve block and glenohumeral steroid injection on the basis of conventional rehabilitation management, while patients in control group received only conventional rehabilitation management. The visual analogue scale (VAS), Constant shoulder scale (CSS) level and shoulder range of motion (ROM) were evaluated before, 2 weeks and 4 weeks after treatment. Results VAS and CSS of research group after 2 and 4 weeks were lower than those before treatment (all P<0.01), also lower than those of control group (all P<0.01). The ranges of shoulder flexion, abduction, internal rotation and external rotation in research group were higher than before treatment (all P<0.01) and higher than those in control group (all P<0.01, except for the range of rotation after 2 weeks of treatment). The recurrence rate in research group 3 and 6 months after treatment were lower than those in control group (both P<0.05). Conclusion Ultrasound-guided suprascapular nerve block and glenohumeral steroid injection can improve the rehabilitation effect of patients with adhesive shoulder capsulitis and decrease recurrence.