超声引导下微创治疗急性肩峰三角肌下滑囊炎的病例对照研究

目的 :评价超声引导下微创治疗急性肩峰三角肌下滑囊炎的疗效。方法 :对2012年6月至2014年3月肩痛患者进行肌骨超声检查,诊断为急性肩峰三角肌下滑囊炎120例,分为治疗组和对照组。治疗组60例,男28例,女32例,平均年龄(56.31±8.23)岁,病程(8.08±1.32)d,采用肌骨超声引导下注射治疗;对照组57例,男24例,女33例,平均年龄(57.39±9.25)岁,病程(7.74±1.29)d,采用病变部位痛点封闭治疗。对患者治疗前后肩关节疼痛、夜间静息痛及功能、二次注射率和综合疗效进行观察评估。结果:两组治疗后肩关节疼痛、夜间静息痛及功能均较治疗前改善,治疗1 d、1周后两组VAS评分对比,治疗组优于对照组;治疗1 d后夜间静息痛治疗组优于对照组;治疗1 d、1周及1个月后两组功能评分比较,治疗组高于对照组。二次注射人数治疗组13例,低于对照组45例。两组综合疗效评定,治疗组痊愈37例,优于对照组21例。结论:超声引导下微创治疗急性肩峰三角肌下滑囊炎较传统封闭疗法起效更快,疗程更短,短期疗效及综合疗效优于传统封闭疗法。

Case-control study on ultrasound-guided microtraumatic treatment of acute subacromial bursitis

Objective: To evaluate the efficacy of ultrasound-guided microtraumatic treatment of acute subacromial bursitis.Methods: The patients with shoulder pain from June 2012 to March 2014 were treated with musculoskeletal bone ultrasound examination. A total of 120 patients were diagnosed with acute subacromial bursitis,who were randomized divided into two groups:US-guided injection group(ultrasound group) and palpation-guided injection group(closed group). The patients in each group were injected with a mixture of 3.5 ml Betamethasone compound lidocaine mixture and 2.5 ml Sodium hyaluronate into the subacromial bursa. The outcome measures were the visual analog scale(VAS) for analyzing pain degree,the night rest pain and Constant-Murley score for detecting shoulder function,rate of secondary injection,and comprehensive effect. The VAS,the night rest pain and CMS were evaluated before,1 day,1 week,and 1 month after the injection.Results: After treatment,the shoulder pain and function were improved. One day and 1 week after the injection,the VAS between the two groups were compared. The pain improvement in ultrasonic group was better than in the traditional group,and the difference was statistically significant(P<0.05). In the two groups,the night rest pain was relieved after treatment,and 1 day after the injection,the night rest pain in the ultrasonic group was significantly lower than that in the traditional group(P<0.05). One day,1 week and 1 mouth after the injection,the CMS between the two groups were compared,and the improvement of CMS in the ultrasonic group was significantly better than that in the traditional group(P<0.05). The patient number with secondary injection in the ultrasonic group was 13 cases,which was significantly less than that in the closed group 45 cases(P<0.05). The recovery number of ultrasonic group was significantly better than that of the traditional group(P<0.05).Conclusion: The ultrasound-guided microtraumatic treatment of acute subacromial bursitis worked faster than traditional closed therapy. The short-term curative effect and the comprehensive curative effect is better than the traditional closed treatment. The US-guided subacromial injection technique is effective in guiding the needle into the subacromial bursa in patients with acute subacromial bursitis.