针刀松解术治疗肩峰下撞击综合征的临床疗效

目的:观察针刀松解术治疗肩峰下撞击综合征的临床疗效。方法:病例来源于2013年9月至2014年8月的肩峰下撞击综合征患者,共90例。其中女61例,男29例;年龄45~65(55.21±8.30)岁;病程1~7(3.49±2.98)个月;左肩26例,右肩64例。局麻下,采用针刀松解肩峰下缘痛点及肩峰下滑囊粘连。通过观察肩关节外展、前屈上举、屈肘内旋、屈肘外旋的活动度,肩关节疼痛评分,统计治疗后治愈、显效、有效、无效的病例数,对针刀治疗肩峰下撞击综合征的疗效进行评价。结果:所有患者顺利完成治疗,无明显不良反应。所有患者完成12个月以上随访,无失访病例。随访VAS疼痛评分1.35±0.78,较术前7.72±5.42减小(t=15.89,P0.01)。术后12个月Constant评分83.17±19.11,较术前58.89±15.63提高(t=28.48,P0.01)。总体疗效评价,治愈46例,显效33例,有效11例,无效0例。结论:针刀治疗肩峰下撞击征的优点是微创地解决根本病变,缺点是不能处理骨质异常引起的撞击。

Clinical results of needle Dao for the treatment of subacromial impingement syndrome

Objective: To study the clinical results of needle Dao for the treatment of subacromial impingement syndrome.Methods: From September 2013 to August 2014,90 patients with subacromial impingement syndrome were treated,including 61 females and 29 males,with the average age of (55.21±8.30) years old(ranged,45 to 65 years old),and mean course of disease (3.49±2.98) months (ranged,4 weeks to 7 months). Twenty-six patients had pains in left shoulder,and 64 patients had pains in right shoulder. Under local anesthesia,needle Dao was performed to release the pain point at the lower edge of the acromion and the subacromial adhesion. By observing the abduction of shoulder joint,anterior flexion and lifting,internal rotation and external rotation,shoulder pain score,the number of cases cured,markedly effective,effective and ineffective after treatment were counted,and the curative effect of needle Dao for the treatment of subacromial impingement syndrome was evaluated.Results: All the patients completed the treatment successfully without obvious adverse reactions. All the patients were followed up for more than 12 months. The visual analogue scale(VAS) decreased from preoperative 7.72±5.42 to postoperative 1.35±0.78(t=15.89,P<0.01). The Constant score at the 12th month after operation increased from preoperative 58.89±15.63 to 83.17±19.11(t=28.48,P<0.01). Overall efficacy evaluation was that,46 cases were cured,33 cases were markedly effective,11 cases were effective,and 0 cases were invalid.Conclusion: The advantage of needle Dao in the treatment of subacromial impingement syndrome is the minimally invasive treatment of the underlying lesions. The disadvantage is that it can not deal with the impact caused by bone abnormalities.