姚丽 应盛国（上海市徐汇区长桥街道社区卫生服务中心 上海 200231）

不同体位手牵足蹬法治疗肩关节前脱位70例临床疗效

姚丽 应盛国
（上海市徐汇区长桥街道社区卫生服务中心 上海 200231）

摘 要目的：观察不同体位手牵足蹬法治疗原发性肩关节前脱位的临床疗效。方法：收集原发性肩关节前脱位患者70例，根据不同体位分为俯卧位手牵足蹬法复位治疗（俯卧位组）35例和仰卧位手牵足蹬法复位治疗（仰卧位组）35例。参照肩关节复位标准评价两组疗效。结果：观察组无麻药复位率为71.43%（25/35），总复位率为94.29%（33/35）；对照组无麻药复位率为62.86%（22/35）,总复位率为80.00%（28/35），组间差异有统计学意义（P＜0.05）。结论：俯卧位手牵足蹬法治疗肩关节前脱位疗效优于仰卧位手牵足蹬法。

关键词肩关节前脱位 不同体位 手牵足蹬法

The clinical effect of reposition by manual reduction at different postures in 70 patients with anterior dislocation of shoulder joint

YAO Li, YING Shengguo
(Changqiao Community Health Service Center of Xuhui District, Shanghai 200231, China)

ABSTRACTObjective: To observe the clinical effect of reposition by manual reduction at different postures in patients with the primary anterior dislocation of shoulder joint. Methods: Seventy patients with the primary anterior dislocation of shoulder joint were collected and divided into a prone position group with 35 cases and a supine position one with 35 ones according to the different postures. The treatment effects of two groups were evaluated with the reference of the standard of shoulder joint reposition. Results: The reposition rate without anesthetic and total reposition rate were 71.43% (25/35) and 94.29% (33/35) in the prone position group and 62.86% (22/35) and 80.00% (28/35) in the supine group. The difference between two groups had the statistical significance (P＜0.05). Conclusion: In the treatment of anterior dislocation of shoulder joint, the effect of Hippocrates (manual reduction) is obviously better in the prone posture than in the supine posture.

KEY WORDSanterior dislocation of shoulder joint; different postures; manual reduction

肩关节脱位中以前脱位为最常见。一般由外伤引起，可导致患者肩部肿胀、疼痛及功能障碍，严重影响患者的工作与生活。手牵足蹬法复位是目前临床上常用的治疗肩关节脱位的方法。本文比较不同体位（俯卧位和仰卧位）手牵足蹬法复位的临床疗效。

1 对象与方法

1.1 对象

收集肩关节前脱位者70例（不包括伴有肱骨外科颈、大、小结节、喙突、肩峰或肩胛盂前下缘骨折患者），其中男性45例，女性25例，年龄18~45岁，均未行手法复位或服用非甾体抗炎类药物，病程均在0.5 d内。将患者分为俯卧位手牵足蹬法复位治疗（观察组）35例和仰卧位手牵足蹬法复位治疗（对照组）35例，两组患者的性别、年龄和病程相比差异均无统计学意义（P＞0.05）。……