[1]潘建科,李嘉晖,杨伟毅,等.麻醉下手法松解联合肩关节周围注射改良“鸡尾酒”及护肩操锻炼治疗冻结肩[J].中医正骨,2021,33(09):56-60.
　PAN Jianke,LI Jiahui,YANG Weiyi,et al.Manipulation under anesthesia combined with peri-shoulder modified cocktail injection and shoulder exercises for treatment of frozen shoulder[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(09):56-60.
点击复制

麻醉下手法松解联合肩关节周围注射改良“鸡尾酒”及护肩操锻炼治疗冻结肩()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年09期
页码:
56-60
栏目:
临床报道
出版日期:
2021-09-20

文章信息/Info

Title:
Manipulation under anesthesia combined with peri-shoulder modified cocktail injection and shoulder exercises for treatment of frozen shoulder
作者:
潘建科; 李嘉晖; 杨伟毅; 候森荣; 肖志锋; 罗明辉; 刘军
(广州中医药大学第二附属医院,广东 广州 510120)
Author(s):
PAN Jianke; LI Jiahui; YANG Weiyi; HOU Senrong; XIAO Zhifeng; LUO Minghui; LIU Jun
关键词:
关节周围炎;  肩凝症;  麻醉;  手法松解;  “鸡尾酒”;  注射;  体操;  康复
摘要:
目的:观察麻醉下手法松解联合肩关节周围注射改良“鸡尾酒”及护肩操锻炼治疗冻结肩的临床疗效和安全性。方法:2019年7月至2021年2月,采用麻醉下手法松解联合肩关节周围注射改良“鸡尾酒”及护肩操锻炼治疗冻结肩患者59例。男19例,女40例。均为单侧冻结肩,左侧30例、右侧29例。年龄40～79岁,中位数57岁。原发性50例,继发性9例。均不合并肩袖撕裂,均不合并血液病、心血管疾病等系统性疾病。均排除银屑病关节炎以及因服用阿那曲唑片、来曲唑片等药物引起的继发性冻结肩,均排除磺胺类药物过敏者。记录术前和术后1 d、1周、1个月患者肩部疼痛视觉模拟量表(visual analogue scale,VAS)评分、Constant-Murley肩关节评分、美国肩肘外科评分,随访观察并发症发生情况。结果:所有患者均获1个月随访。患者肩部疼痛VAS评分随时间呈下降趋势[(5.68±1.12)分,(2.24±0.92)分,(2.42±0.67)分,(1.19±0.71)分,F=299.683,P=0.000],Constant-Murley肩关节评分和美国肩肘外科评分随时间均呈上升趋势[(44.17±4.84)分,(84.08±6.76)分,(88.31±3.98)分,(89.07±3.74)分,F=1 446.927,P=0.000;(43.03±5.05)分,(85.85±8.17)分,(89.93±4.72)分,(91.24±4.24)分,F=1 000.165,P=0.000]。均未发生严重胃肠道反应和肩周软组织再次粘连等并发症。结论:采用麻醉下手法松解联合肩关节周围注射改良“鸡尾酒”及护肩操锻炼治疗冻结肩,能够显著缓解肩部疼痛,改善肩关节功能,且安全性高。

参考文献/References:

[1] 陈荣庄,高彦平.关节腔注射联合温针灸治疗早期冻结肩[J].中医正骨,2019,32(6):38-40.
[2] 陈啸,黄竞敏,杨彤旭.冻结肩的中西医治疗研究进展[J].中国中西医结合外科杂志,2021,27(4):662-666.
[3] CHO C H,BAE K C,KIM D H.Treatment strategy for frozen shoulder[J].Clin Orthop Surg,2019,11(3):249-257.
[4] 李会会,王翔,詹红生.“凝肩”的中西医诊治进展[J].中国中医骨伤科杂志,2019,27(9):85-88.
[5] 徐逸生,杨伟毅,吕燃,等.鸡尾酒配方灌注对肩周炎关节松动术康复效果的影响[J].广东医学,2018,39(4):593-596.
[6] 刘玉杰.实用关节镜手术学[M].北京:化学工业出版社,2017:465-466.
[7] 蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2005.
[8] 曹寅生,万云峰,易强,等.肩关节腔内药物联合注射治疗原发性冻结肩[J].中医正骨,2019,31(7):40-43.
[9] GEORGIANNOS D,MARKOPOULOS G,DEVETZI E,et al.Adhesive capsulitis of the shoulder.Is there consensus regarding the treatment?A comprehensive review[J].Open Orthop J,2017,11:65-76.
[10] UESHIMA H,OTAKE H.Pectoral nerves 1 block is effective for silent manipulation of frozen shoulder[J].J Clin Anesth,2018,44:47.
[11] WANG Y X,ZHOU A.A new improvement:subperiosteal cocktail application to effectively reduce pain and blood loss after total knee arthroplasty[J].J Orthop Surg Res,2020,15(1):33.
[12] WANG Q R,SUN J K,HU Y L,et al.Effects of morphine on peri-articular infiltration analgesia in total knee arthroplasty:a prospective,double-blind,randomized controlled trial[J].Int Orthop,2020,44(12):2587-2595.
[13] IWAKIRI K,MINAMI Y,OHTA Y,et al.Effect of periarti-cular morphine injection for total knee arthroplasty:a randomized,double-blind trial[J].J Arthroplasty,2017,32(6):1839-1844.
[14] DENG Z H,LI Y S,STORM G R,et al.The efficiency and safety of steroid addition to multimodal cocktail periarticular injection in knee joint arthroplasty:a meta-analysis of randomized controlled trials[J].Sci Rep,2019,9(1):7031.
[15] FAN Z R,MA J X,KUANG M J,et al.The efficacy of dexamethasone reducing postoperative pain and emesis after total knee arthroplasty:a systematic review and meta-analysis[J].Int J Surg,2018,52:149-155.
[16] 张民.小剂量罗哌卡因麻醉在老年膝髋关节置换中的价值[J].泰山医学院学报,2020,41(8):589-590.
[17] XIAO X,ZHANG Q,OUYANG Z X,et al.Comparison of perioperative flurbiprofen axetil or celecoxib administration for pain management after total-knee arthroplasty:a retrospective study[J].Medicine(Baltimore),2018,97(37):e12391.
[18] KRAVANJA G,PRIMOIC M,KNEZ ,et al.Chitosan-based(Nano)materials for novel biomedical applications[J].Molecules,2019,24(10):1960.
[19] MELAMED E,BEUTEL B G,ROBINSON D.Enhancement of acute tendon repair using chitosan matrix[J].Am J Orthop(Belle Mead NJ),2015,44(5):212-216.
[20] DEPRES-TREMBLAY G,CHEVRIER A,SNOW M,et al.Freeze-dried chitosan-platelet-rich plasma implants improve supraspinatus tendon attachment in a transosseous rotator cuff repair model in the rabbit[J].J Biomater Appl,2019,33(6):792-807.
[21] 李君,齐昊,付昆.关节镜松解术联合医用几丁糖注射治疗冻结肩的临床疗效分析[J].中国中医骨伤科杂志,2019,27(4):56-58.
[22] ESAIN I,GIL S M,BIDAURRAZAGA-LETONA I,et al.Effects of 3 months of detraining on functional fitness and quality of life in older adults who regularly exercise[J].Aging Clin Exp Res,2019,31(4):503-510.
[23] 张帆,詹红生,王庆来,等.背后臂屈伸锻炼配合手法治疗粘连性肩周炎[J].中国骨伤,2020,33(7):662-664.

相似文献/References:

[1]曹廷生,胡海军,董晓明,等.复方川紫方萃取油刮痧治疗瘀滞型肩周炎[J].中医正骨,2016,28(07):57.
[2]何文全,苏进益,陆红日,等.独活寄生颗粒治疗大鼠肩周炎的效果和作用机制研究[J].中医正骨,2022,34(06):1.
　HE Wenquan,SU Jinyi,LU Hongri,et al.Efficacy and mechanism of Duhuo Jisheng(独活寄生)granules against scapulohumeral periarthritis in rats:an experimental study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(09):1.
[3]刘怀省,韩文朝,王冠军,等.超声引导肌间沟入路臂丛神经麻醉下手法松解治疗粘连期肩周炎[J].中医正骨,2023,35(01):61.
[4]侯俊成,张善华,周海伟,等.三维稳态采集快速成像序列在肩周炎患者喙肱韧带MRI扫描中的应用价值[J].中医正骨,2023,35(02):22.
[5]成子己,管翀,顾元嘉,等.传统功法在肩周炎治疗中的应用进展[J].中医正骨,2022,34(06):34.
[6]王楠,赵明宇,寇赵淅,等.基于平乐正骨筋滞骨错理论探讨肩周炎的病机及治疗方法[J].中医正骨,2023,35(06):56.

备注/Memo

备注/Memo:
基金项目:广东省中医药局科研项目(20181119); 广东省中医院中医骨伤科传统特色疗法传承创新研究和畅气通络推拿法治疗肩周炎临床研究项目(粤财社〔2018〕8号)
通讯作者:刘军 E-mail:liujun.tcm@163.com。
更新日期/Last Update: 1900-01-01