王守立　　朱虹　　周晓波　　韩大伟　　江玲军

[摘要] 目的 探讨关节镜下松解关节囊治疗冻结肩的临床疗效。 方法 选取2013年6月～2016年4月间采用关节镜下松解术治疗冻结肩患者61例，男19例，女42例；年龄35～69岁，平均54岁。记录VAS评分、UCLA肩关节评分、肩关节活动度和并发症。 结果 61例患者均获得随访，随访时间12～36个月，平均22个月。切口均Ⅰ/甲愈合，VAS评分从术前（7.9±1.3）分提高到术后（2.1±0.9）分，UCLA肩关节评分从术前（13.8±3.9）分提高到（30.9±3.2）分，肩关节各方向活动度均较术前明显提高。均未出现关节感染、神经损伤、血管损伤及因韧带关节囊松解后出现关节脱位等并发症。 结论 关节镜下松解术治疗冻结肩安全有效。

[关键词] 冻结肩；松解；关节镜；手术

[中图分类号] R681.7 [文献标识码] A [文章编号] 1673-9701（2018）17-0021-03

Clinical effectiveness of arthroscopy release for frozen shoulder

WANG Shouli ZHU Hong ZHOU Xiaobo HAN Dawei JIANG Lingjun

Department of Joint Surgery， Taizhou Hospital of Zhejiang Province， Linhai 317000， China

[Abstract] Objective To investigate the clinical effectiveness of arthroscopic capsular release in patients with frozen shoulder. Methods 61 patients（19 male and 41 female） with frozen shoulder who had been through the treatment of arthroscopic release in our hospital from June， 2013 to April， 2016 were selected. The patients aged 35 to 69 years and their average age was 54 years old. The scores of VAS， UCLA shoulder scoring system， range of motion of shoulder and the incidence of complications were recorded. Results All of 61 patients were followed up. The time of follow-up ranged from 12 to 36 months and averaged 22 months. All the incision healing was I/first rate. The VAS score increased [from （7.9±1.3） before operation to （2.1±0.9） after operation]. The score of UCLA shoulder scoring system increased （from （13.8±3.9） before operation to （30.9±3.2） after operation）. The range of motion of shoulder in each direction improved significantly when compared with that before operation. There were no cases with joint infection， nerve injury， vascular injury or joint dislocation after ligament-capsular release. Conclusion Arthroscopic release in patients with frozen shoulder was effective and safe.

[Key words] Frozen shoulder； Release； Arthroscopy； Surgery

凍结肩，或称粘连性关节囊炎，是一种常见的骨骼肌疾病，以肩关节疼痛、活动受限为主要表现。正常人群中冻结肩每年的发生率为2%，女性在40～50岁间发病率较高[1]。既往认为此疾病呈自限性，但最近的研究发现其病程可长达10年之久。冻结肩的治疗方法有多种，包括理疗、口服非甾体类消炎药（NSAIDs）、肩胛上神经阻滞、注射类固醇药物及麻醉下的手法松解[2-4]，但有些患者对这些治疗方法没有效果，关节镜下松解术在治疗顽固性冻结肩中起着重要作用。本研究于2013年6月～2016年4月间采用关节镜下松解治疗冻结肩患者61例，现报道如下。

1 资料与方法

1.1 一般资料

本组61例患者均为本院行关节镜下松解术的冻结肩患者，符合《常见疾病的诊断与疗效（标准）》中冻结肩的诊断标准[5]。……