超声引导下曲安奈德联合玻璃酸钠注射治疗粘连性肩关节囊炎的疗效观察

目的:评价超声引导下曲安奈德联合玻璃酸钠注射治疗粘连性肩关节囊炎的临床疗效。方法:将符合粘连性肩关节囊炎诊断患者44例,随机分为2组。对照组给予常规康复治疗、药物治疗及健康教育,并予以超声引导下曲安奈德注射治疗,观察组在对照组的基础上,增加玻璃酸钠注射治疗,均为期4周治疗。分别于治疗前、治疗2周、治疗4周、治疗后8周随访进行疼痛视觉模拟评分(VAS)、肩关节功能活动评分(Melle)、匹兹堡睡眠质量指数(PSQI)评定。结果:治疗2周,2组VAS、Melle及PSQI评分均较治疗前明显下降(均P0.05),但2组间相比较差异无统计学意义;治疗4周后,2组VAS、Melle及PSQI评分均较治疗前及治疗2周时有明显下降(均P0.05),且观察组各项评分明显优于对照组(均P0.05)。治疗后8周随访,2组VAS、Melle及PSQI评分均较治疗前及治疗2周时均有不同程度的下降(均P0.05),且观察组各项评分优于对照组(均P0.05);但较治疗4周相比较,2组患者虽各项指标评分有所变化,但差异无统计学意义。将VAS疼痛评分与PSQI睡眠质量改善程度进行相关性分析发现,VAS疼痛改善程度与患者睡眠质量指数PSQI提高呈正相关(r=0.732,P=0.031)。结论:超声引导下曲安奈德联合玻璃酸钠注射治疗可有效减轻粘连性肩关节囊炎患者疼痛、改善肩关节活动功能及提高睡眠质量,其临床疗效优于单一曲安奈德注射治疗;另疼痛改善与睡眠质量指数提高具有正相关性。

Effectiveness of ultrasound-guided tricinolone combined with hyaluronic acid injection for scapulohumeral periarthritis

Objective: To evaluate the effectiveness of ultrasound-guided triacinolone combined with hyaluronic acid injection for scapulohumeral periarthritis. Method: Forty-four cases of scapulohumeral periarthritis were randomly divided into observation group and control group, 22 patients in each group. All patients were given conventional rehabilitation training, drug therapy, health education, and ultrasound guided triamcinolone injection. The observation group was given hyaluronic acid injection additionally. Both groups were treated for 4 weeks. VAS, Melle and PSQI scores of patients were assessed before, and 2, 4 weeks after treatment, Patients were followed up at 8th week after treatment. Results: After treatment for 2 weeks, scores of VAS, Melle and PSQI were significantly decreased in both groups as compared with those before treatment (all P<0.05), but there was no statistically significant difference between the two groups (P>0.05). After treatment for 4 weeks, scores of VAS, Melle and PSQI in both groups were significantly decreased as compared with those before treatment and at 2nd week after treatment (all P<0.05), more significantly in observation group than in control group (P<0.05).Patients were followed up from 8th week after treatment, scores of VAS, Melle and PSQI in both groups were reduced to varying degrees as compared with those before treatment and at 2nd week after treatment (all P<0.05), more significantly in observation group than in control group (P<0.05), but they were not different from those at 4th week after treatment. The alleviation of pain was positively correlated with the improvement of sleep quality index (r=0.732). Conclusion: Ultrasound-guided triamcinolone combined with hyaluronic acid injection can effectively reduce the pain of patients with scapulohumeral periarthritis, and improve the function of shoulder joint movement and the quality of sleep, and its clinical effect is superior to that of single triamcinolone injection. Moreover, there was a positive correlation between pain improvement and sleep quality index improvement.