曾 波梁 英陈晓青赵立飞



超声引导下药物精准注射治疗肩袖损伤的研究

曾 波1梁 英2陈晓青2赵立飞2

【摘要】目的 研究肌骨超声引导下复方倍他米松精准注射对肩袖损伤的疗效。方法 选取30例经核磁共振成像（MRI）检查确诊为肩袖损伤的患者，给予肌骨超声引导下复方倍他米松精准注射治疗，分别于治疗前、治疗后即刻、治疗后1周、治疗后2周及治疗后4周评定患侧肩的VAS评分、主动前屈关节活动度（AFROM）及外展关节活动度（AAROM）。结果 经治疗前后比较，发现患者于注射后即刻、注射后1周、注射后2周及注射后4周患侧肩的VAS评分均有降低，肩的主动前屈、外展关节活动度均有增加，与治疗前相比差异均具有统计学意义（P ＜0．05）。结论 肌骨超声引导下精准注射复方倍他米松可缓解肩袖损伤的肩痛，增加肩关节活动度，提高肩关节功能。

【关键词】肩袖损伤；肌骨超声引导；精准注射；复方倍他米松注射液

2 山西大医院康复医学科，山西 太原 030032

Objective To research the treatment effectiveness of ultrasound-guided shoulder injection of betamethasone in the treatment of rotator cuff injury．Methods Thirty rotator cuff injured patients who were confirmed by magnetic resonance imaging（MRI）were involved in this study． The patients were treated with ultrasound-guided shoulder injection of betamethasone． The shoulder active flextion range of motion （AFROM） and active abduction range of motion （AAROM） and visual analogue score （VAS） were compared before treatment and immediately，1 week ，2 weeks and 4 weeks after treatment． Results Compared with pretreatment，there were significantly increased in AFROM and AAROM and decreased in VAS score at immediately after treatment，1 week，2 weeks and 4 weeks posttreatment （both P＜0．05）． Conclusion Ultrasound-guided accurate injection of betamethasone is effective in treating rotator cuff injury． The technique can relieve the pain obviously and rapidly，and increase the shoulder active flextion and abduction range of motion，and improve the function of shoulder．

【Key words】 Rotator cuff injury，Musculoskeletal ultrasound-guided，Accurate injection，Betamethasone

肩袖起自肩胛骨，由冈上肌、冈下肌、小圆肌和肩胛下肌四块肌肉组成，因在肱骨头解剖颈处形成袖套状而得名。肩袖损伤（Rotator cuff injury）是一种以肩痛、肩关节主动活动受限为主，伴有肩周肌群力弱及肌肉萎缩等临床特征的常见病［1］。肩袖损伤多见于40岁以上的中老年人［2］。

目前国内应用超声检查对肩袖损伤进行诊断的研究已经很多，而利用超声引导对肩袖损伤进行药物精准注射治疗较少。肌骨超声（musculoskeletal ultrasound，MSUS）是指应用于肌肉骨骼系统的超声诊断技术，能较清晰的在超声图像上显现出肌腱的撕裂程度及滑囊积液， 如冈上肌肌腱急性损伤多会出现肩峰下滑囊积液［3］。……