神经阻滞下粘连松解术与关节松动术治疗粘连性肩周炎的疗效评价

目的比较臂丛阻滞和星状神经节阻滞下分别配合粘连松解术和关节松动术治疗粘连性肩周炎的疗效。方法60例粘连性肩周炎患者随机分为4组,每组15例：Ⅰ组：臂丛阻滞下粘连松解术;Ⅱ组：臂丛阻滞下关节松动术;Ⅲ组：星状神经节阻滞下粘连有限松解术;Ⅳ组：星状神经节阻滞下关节松动术;记录治疗方法及次数、治疗前后疼痛程度以及肩关节运动功能状态。结果近期疗效优良率Ⅳ组显著优于其他3组（P〈0.05）;神经阻滞＋手法治疗次数及痛点注射治疗次数Ⅰ组与Ⅱ、Ⅲ、Ⅳ组相比差异有显著的统计学意义（P〈0．01）。结论星状神经节阻滞下关节松动术疗效最好,对关节功能的改善更为显著,且患者无手臂麻木无力引起的不适感,治疗依从性较好。

Effects of adhesion releasing under nerve block and arthrolysis on adhesive scapulohumeral periarthritis: a comparative study

OBJECTIVE: To compare the effects of adhesion releasing under nerve block and arthrolysis on adhesive scapulohumoral periarthritis. METHODS: Sixty patients with adhesive scapulohumoral periarthritis 24 males and 36 females, aged 52.5 (40 - 67), were randomly divided into 4 equal groups: Group I, undergoing adhesion releasing under brachial plexus block, Group II, undergoing adhesion releasing under stellate ganglion block, Group III, undergoing limited adhesion releasing under stellate ganglion block, and Group IV undergoing arthrolysis under stellate ganglion block. The clinical effects were recorded and compared. RESULTS: The short-term effect of Group IV was significantly superior to the other 3 groups (all P < 0.05). The frequency of block + manipulation treatment of Group I was significantly less than those of the other 3 groups (all P < 0.01), and the frequency of pain point injection of Group I was significantly higher than those of the other 3 groups (all P < 0.01). CONCLUSION: The 4 methods are all effective for the treatment of adhesive scapulohumoral periarthritis. In particular, arthrolysis under stellate ganglion block shows greater improvement in the joint function and less uncomfortableness caused by numbness and weakness of the arm.