超声引导下小针刀联合双针穿刺抽吸治疗钙化性冈上肌腱炎的临床观察

目的探讨改良型超声引导下小针刀经皮穿刺联合双针抽吸治疗钙化性冈上肌腱炎的效果及安全性。方法将60例钙化性冈上肌腱炎患者随机分为对照组和观察组,每组各30例。对照组在超声引导下先以小针刀穿刺后再行单针头经皮抽吸治疗;观察组在超声引导下先以小针刀穿刺后再行双针头经皮抽吸治疗。两组分别于治疗前,治疗后3 d、7 d、1个月、6个月采用数字评价量表(NRS)评价患者疼痛程度;采用美国加州大学肩关节评分系统(UCLA)和Constant-Murley肩关节功能评分系统评价患者肩关节功能和活动范围。比较两组患者DR片检查结果及二次、三次治疗比率。同时记录治疗和随访期间不良反应发生情况。结果两组患者治疗前NRS评分比较,差异无统计学意义;治疗后3 d、7 d观察组患者NRS评分均低于对照组,差异均有统计学意义(均P<0.05);治疗后1个月、6个月两组NRS评分比较差异均无统计学意义。两组患者治疗前与治疗后3 d、7 d、1个月、6个月UCLA评分和Constant-Murley评分比较差异均无统计学意义。观察组患者DR片显示,治疗后7 d钙化灶减小或消失。观察组患者二次、三次治疗比率均低于对照组,差异均有统计学意义(均P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义。结论与传统超声引导下小针刀联合单针头抽吸术比较,超声引导下小针刀联合双针头穿刺抽吸治疗钙化性冈上肌腱炎可在早期缓解患者症状,治疗效果显著,具有较好的安全性。

Clinical observation on the treatment of calcified supraspinatustendinitis with needle-knife and double-needlesuction under ultrasound guidance

Objective To investigate the efficacy and safety of ultrasound-guided percutaneous needle-knife puncture combined with double-needle suction for the treatment of calcific supraspinatus tendinitis.Methods Sixty patients with calcified supraspinatus tendinitis were selected and divided into control group and observation group randomly,30 cases in each group.Patients in the control group was treated by a needle-knife combined with single-needle percutaneous suction under the guidance of ultrasound,while the observation group was treated by a needle-knife combined with double-needle percutaneous suction.The degree of pain was evaluated by numerical rating scale(NRS),the shoulder function and range of motion were evaluated using the university of California at Los Angeles shoulder rating scale(UCLA) and the Constant-Murley Shoulder Function Score System before treatment and 3 d,7 d,1 month and 6 months after treatment.The results of DR examination and the ratio of second and third treatments were compared between two groups.The incidence of adverse reactions during treatment and follow-up was also recorded.Results There was no significant difference in terms of NRS socre between two groups before treatment.At 3 d and 7 d after treatment,the NRS score of the observation group were lower than that of the control group(both P<0.05).At 1 month and 6 months after treatment,the NRS scores of the two groups were not significantly different.There were no significant differences in UCLA score and Constant-Murley score between two groups before and after treatment.The results of DR in the observation group showed that the calcifications decreased or disappeared at 7 d after treatment.The ratio of second and third treatment of the observation group were significant lower than the control group(both P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment.Conclusion Compared with the traditional ultrasound-guided needle-knife combined with single-needle percutaneous suction,ultrasound-guided needleknife combined with double-needle percutaneous suction for treatment of calcified supraspinatus tendinitis can reduce pain of patients in the early stage,with significant therapeutic effects and good safety.