摘要
背景:应用玻璃酸钠关节腔内注射联合类固醇激素类药物行神经阻滞在膝关节骨性关节炎患者中获得了非常满意的临床效果,联合治疗对肩周炎的治疗效果如何?目的:探讨玻璃酸钠肩关节腔内注射结合倍他米松行神经及痛点阻滞改善肩周炎患者疼痛变化及关节功能。设计:自身前后对照实验。单位:首都医科大学附属北京天坛医院。对象:纳入首都医科大学附属北京天坛医院疼痛门诊2004-01/10就诊的肩周炎患者20例,年龄40～65岁。方法:对20例肩周炎患者行肩关节腔内注射玻璃酸钠与倍他米松行神经及痛点阻滞联合治疗,于治疗前和治疗后1周时记录。①疼痛症状:采用目测类比评分,以“没有任何疼痛感觉”为0分,“设想的不能忍受的疼痛”为10分,记录安静时、运动时疼痛评分。②日常生活活动的评分:按5级法记录,4分为全部做不到;3分经他人帮助可以做到;2分自己勉强可以做到,多半感到不便;1分自己勉强可以做到,不太感到不便;0分与正常人一样可以做到。主要观察指标:①肩周炎患者安静和运动时疼痛评分。②日常生活活动评分。结果:按实际处理分析,20例患者均进入结果分析。①安静时目测类比评分:治疗1周后低于治疗前[(4.34±1.33),(8.27±1.37)分,P<0.01]。②运动时目测类比评分:治疗1周后低于治疗前[(4.73±1.31),(8.49±1.35)分,P<0.01]。③日常生活动作评分:治疗1周后低于治疗前[(1.10±0.74),(3.30±0.48)分,P<0.01]。结论:肩关节腔内注射玻璃酸钠结合倍他米松行神经及痛点阻滞可有效治疗肩周炎,且无明显不良反应发生,值得在疼痛治疗中推广应用。
BACKGROUND： Very satisfactory clinical effects have been achieved in treatment of osteoarthritis of knee with intraarticular injection of sodium hyaluronate （SH） allied with steroid hornmnes for nerve block. How will such allied treatment be used for periarthritis of shoulder？ OBJECTIVE： To probe into the improvement of pain and joint function in periarthritis of shoulder treated with integration of intraarticular injection of SH with nerve and pain block with betamethasone. DESIGN： Self-control was designed before and after experiment. SETTING： Beijing Tiantan Hospital, Capital University of Medical Sciences PARTICIPANTS： Twenty patients with periarthritis of shoulder were included, aged from 40 to 65 years from Pain Clinic of Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences from January to October 2004. METHODS： Integration of intraarticular injection of SH with nerve and pain block with betamethasone was applied to treat 20 cases of periarthritis of shoulder and the record was done before treatment and 1 week after treatment.① Pain： visual analogue scale （VAS） was adopted, in which, “no any pain sensation” was 0 score,“unable to bear pain with imagination” was 10 scores. Pain score was recorded during quiet and movement stages.② Evaluation of daily life activity： 5 grades were involved. 4 scores indicated being impossible completely, 3 scores indicate being possible with help, 2 scores indicate being possibled reluctantly and mostly feeling inconvenient, 1 score indicated being possible reluctantly without inconvenience and 0 score indicated being possible as healthy person. MAIN OUTCOME MEASURES： ① Evaluation of pain during quiet and moving stages in patients with periarthritis of shoulder. ② Evaluation of daily life activity. RESULTS： According to practical management and analysis, 20 cases entered result analysis. ①VAS at quiet stage： it was lower 1 week after treatment compared with that before treatment [（4.34±1.33）,（8.27±1.37）scores, P 〈 0.01]. ②VAS at moving stage： it was lower 1 week after treatment compared with that before treatment [（4.73±1.31）, （8.49±1.35）scores, P 〈 0.01]. ③VAS of daily life activity： it was lower 1 week after treatment compared with that before treatment [（1.10±0.74）, （3.30±0.48） scores, P 〈 0.01]. CONCLUSION： Integration of intraarticular injection of SH with nerve and pain block with betamethasone treats effectively periarthritis of shoulder, without remarkably harmful reaction and it is worth in popularization in treatment of pain.
出处
《中国临床康复》
CSCD
北大核心
2005年第30期266-267,共2页
Chinese Journal of Clinical Rehabilitation
作者简介
罗芳，女，1971年生，四川省广安县人，汉族，2003年首都医科大学毕业，博士，主治医师，主要慢性疼痛治疗的研究。
