蒋伟，江文杰，郭燕芬，葛志军

江苏大学附属宜兴市人民医院麻醉科，江苏宜兴214200

超声引导下肩峰下滑囊联合结节间沟注射治疗肩周炎的效果探讨

蒋伟，江文杰，郭燕芬，葛志军

江苏大学附属宜兴市人民医院麻醉科，江苏宜兴214200

目的 研究超声引导下肩峰下滑囊联合结节间沟注射辅以功能锻炼治疗肩周炎的临床效果。方法 方便选择2013年9月—2015年9月该院疼痛门诊肩峰下滑囊炎合并肱二头肌长头肌腱炎患者60例，通过抽签随机分成超声组（30例）和对照组（30例），超声组采用超声定位，对照组采用传统解剖定位。使用VAS疼痛评分和Constant-Murley（CMC）肩关节功能评分分别评价两组治疗前、治疗后肩周炎情况。结果 超声组治疗前的VAS（7.23±0.85）分和CMC总得分（40.36±6.38）分评分与对照组（7.36±0.92）分、（38.63±4.5）分相比差异无统计学意义，治疗后超声组VAS（1.7± 0.18）分、CMC总得分（70.43±4.85）分，治疗后对照组VAS（4.5±1.25）分、CMC总得分（57.8±3.84）分相比差异有统计学意义（P＜0.05），两组组内治疗前后差异均有统计学意义（P＜0.05）。结论 超声引导下肩峰下滑囊联合结节间沟注射镇痛复合液辅以功能锻炼是治疗肩关节炎的有效方法，效果优于传统解剖定位注射。

肩周炎；超声引导；肩峰下滑囊；结节间沟

［Abstract］Objective To investigate the clinical effect of ultrasound guided subacromial bursa combined with interubercular sulcus injection and functional exercise in the treatment of scapulohumeral periarthritis.Methods Convenient selection sixty patients with subacromial bursitis and myotenositis of long head of biceps brachii who were treated in the pain clinic of our hospital between September 2013 and September 2015 were randomized into ultrasound group（30 cases）and control group（30 cases）.Ultrasonic locating was performed in ultrasound group while traditional anatomical locating was performed in control group.VAS pain score and Constant-Murley（CMC）shoulder joint function score were used to evaluate the status of scapulohumeral periarthritis in the two groups before and after treatment.Results Before treatment，there were no significant differences in VAS scores（7.23±0.85）points vs（7.36±0.92）points and CMC total scores（40.36±6.38）points vs（38.63±4.5）points］between ultrasound group and control group.After treatment，the differences in VAS scores（1.7±0.18）points vs（4.5± 1.25）points and CMC total scores（70.43±4.85）pointsvs（57.8±3.84）points between ultrasound group and control group were significant（P＜0.05）.The differences within the two groups before and after treatment were significant（P＜0.05）.Conclusion Ultrasound guided subacromial bursa combined with interubercular sulcus injection and functional exercise is an effective method for treating scapulohumeral periarthritis，and the effect is better than the traditional anatomical located injection.

［Key words］Scapulohumeral periarthritis；Ultrasound guided；Subacromial bursa；Intertubercularis sulcus

肩周炎是指肩关节囊和关节周围软组织损伤、退变而引起的慢性无菌性炎症，并致关节内外粘连的一种疾病［1］。多发于40岁以上的中老年人，发病率女性略高于男性，约为1.3：1，临床表现主要为肩关节部疼痛、运动功能障碍和肌肉萎缩［2］。传统解剖定位肩峰下滑囊联合结节间沟注射术是治疗肩峰下滑囊炎合并肱二头肌长头肌腱炎的常用方法，但其效果并不十分理想［3］。……