摘要
目的探讨超声在冻结肩诊疗及疗效评估中的应用价值。方法选取2018年7月至2019年6月在唐山市丰润区人民医院临床诊断为冻结肩的患者70例为病例组,同时期健康志愿者29名共58个肩关节为对照组,比较两组盂肱关节囊厚度。病例组患者68例进行2次超声引导下关节腔注射并液压扩张,间隔一周,每次治疗前及第二次治疗后2周测量关节囊厚度并进行临床评分。结果病例组关节囊厚度较对照组明显增厚[(3.88±1.34)mm vs(1.68±0.59)mm],差异有统计学意义(t=12.339,P<0.001),当关节囊厚度为2.65 mm时诊断敏感度为87%,特异度为95%,曲线下面积0.953。病例组第一次治疗后关节囊厚度[(3.86±1.06)mm]较前无明显变化,差异无统计学意义(P>0.05),第二次治疗后关节囊厚度[(3.06±0.95)mm]较治疗前及第一次治疗后减小,差异均有统计学意义(t=2.606、2.148,P均<0.05)。第一次与第二次治疗后数字模拟评分法(VAS)评分均较治疗前降低,差异均有统计学意义(t=2.711、2.867,P均<0.05),肩关节活动度评分均较前增高,差异均有统计学意义(t=3175、3.466,P均<0.05),第二次与第一次治疗后相比,VAS评分降低,差异有统计学意义(t=2.591,P<0.05),肩关节活动度无明显变化,差异无统计学意义(P>0.05)。结论超声对诊断冻结肩有重要意义,可视化诊疗技术(超声)治疗安全简便,并且能够有效评估疗效。
Objective To evaluate the value of ultrasound in the treatment and evaluation of frozen shoulder.Methods Seventy frozen shoulders of 70 patients(case group)and 58 normal shoulders of 29 healthy volunteers(control group)were included in the study.The interior capsule thickness was compared between the two groups.Sixty-eight shoulders of the case group underwent ultrasound-guided glenohumeral joint injection combined with hydraulic dilatation.Interior capsule thickness,Visual Analogy Scale(VAS)score,and Constant-Murley score were assessed before each treatment and 2 weeks after the second treatment.Results The interior capsule was significantly thicker in the case group than in the control group[(3.88±1.34)mm vs(1.68±0.59)mm,t=12.339,P<0.001].The interior capsule thickness had a diagnostic sensitivity of 87%,specificity of 95%,and area under the curve of 0.953.After the first treatment,VAS score and active range of motion(AROM)were significantly improved compared with pretreatment values,but the interior capsule thickness was not significantly changed(P>0.05).After the second treatment,the interior capsule thickness was significantly decreased compared with pre-treatment values and the values after the first treatment(t=2.606 and 2.148,respectively,P<0.05).VAS score and AROM after the first and second treatment were significantly improved(t=2.711 and 2.867,respectively,P<0.05)compared with pre-treatment values.The interior capsule thickness after the second treatment was significantly decreased compared with the first treatment(t=3175,3.466,P<0.05),and the pain was significantly improved(t=2.591,P<0.05),but AROM was not significantly improved(P>0.05).Conclusion Ultrasound is a useful tool of diagnosis and evaluation of frozen shoulder.It is safe,simple,and effective to use ultrasound-guided genohumeral joint injection combined with hydraulic dilatation for the treatment of frozen shoulder.
作者
尹莉
梁晓宁
马秀清
宓士军
韩梅
郭瑞君
Yin Li;Liang Xiaoning;Ma Xiuqing;Mi Shijun;Han Mei;Guo Ruijun(Department of Ultrasound,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China;Department of Musculoskeletal and Interventional Ultrasound,Tangshan Fengrun People′s,Tangshan 064000,China)
出处
《中华医学超声杂志（电子版）》
CSCD
北大核心
2019年第11期810-814,共5页
Chinese Journal of Medical Ultrasound(Electronic Edition)
作者简介
通信作者:郭瑞君,Email:ruijunguo@126.com。
