兰剑　白永权　覃东亮　姚志国　赵培龙

[摘要] 目的 評估冻结期原发性冻结肩中关节镜下关节囊松解术治疗效果。 方法 方便选取该院2016年3月—2018年7月收治的54例冻结期原发性冻结肩患者为研究案例，男性患者22例，女性患者32例，平均年龄（61.7±7.8）岁，术前采取正规保守康复治疗无效，所有患者均全麻下采用关节镜下关节囊松解术治疗，术后第2天开始行功能康复锻炼，对原发性冻结肩患者术前、术后肩关节外展角度与前屈角度、内收位外旋角度等情况，肩关节功能评分与VAS评分进行观察对比。 结果 原发性冻结肩患者术后肩关节平均外展角度与前屈角度、内收位外旋角度（121.32±10.73）°﹥（50.38±10.57）°，（122.36±15.23）°﹥（75.49±6.78）°、（68.4±11.6）°﹥（8.3±1.2）°明显超过术前，比较差异有统计学意义（t=14.365、14.218、15.374，P=0.000﹤0.05）。原发性冻结肩患者术后平均肩关节功能评分（83.21±10.56）分明显超过术前（23.57±8.46）分，比较差异有统计学意义（t=24.382，P=0.000﹤0.05）;原发性冻结肩患者术后平均VAS评分（2.37±0.93）分明显低于术前（7.98±1.32）分，比较差异有统计学意义（t=23.279，P=0.000﹤0.05）。 结论 在冻结期原发性冻结肩治疗方面，关节镜下关节囊松解术治疗能够有效缓解患者疼痛症状，促进关节功能恢复，同时具有微创的优点。

[关键词] 冻结期;原发性冻结肩;关节镜;关节囊松解术;治疗效果;评估分析

[中图分类号] R4          [文献标识码] A          [文章编号] 1674-0742（2019）05（a）-0008-04

[Abstract] Objective To evaluate the effect of arthroscopic capsulolysis of primary frozen shoulder during frozen period. Methods Fifty-four patients with frozen shoulder treated in our hospital from March 2016 to July 2018 were convenient selected as study cases. There were 22 males and 32 females with an average age of （61.7±7.8） years. Preoperative conservative rehabilitation was ineffective. All patients were treated with arthroscopic capsulolysis under general anesthesia， and the second one after operation. The shoulder joint abduction angle， flexion angle， adduction and extroversion angle， shoulder joint function score and VAS score were observed and compared before and after primary frozen shoulder surgery. Results The average abduction angle， flexion angle， adduction and extroversion angle of shoulder joint in patients with primary frozen shoulder after operation were significantly higher than those before operation （121.32±10.73）°>（50.38±10.57）°， （122.36 ±15.23）°>（75.49±6.78）°， （68.4±11.6）°>（8.3±1.2）°. The difference was statistically significant （t=14.365， 14.218， 15.374， P=0.000<0.05）. The average functional score of shoulder joint after operation in patients with primary frozen shoulder was （83.21±10.56）points， which was significantly higher than that before operation （23.57±8.46）points， the difference was statistically significant （t=24.382， P=0.000<0.05）. The average VAS score after operation in patients with primary frozen shoulder（2.37±0.93）points was significantly lower than that before operation （7.98±1.32）points， and the difference was statistically significant （t=23.279， P=0.000<0.05）. Conclusion Arthroscopic capsulolysis can effectively relieve pain symptoms and promote the recovery of joint function in the treatment of frozen primary frozen shoulder， which is worthy of reference by the hospital.

[Key words] Freezing period; Primary frozen shoulder; Arthroscopy; Arthrolysis of articular capsule; Therapeutic effect; Evaluation and analysis

冻结肩是临床常见肩部疾病，临床多采用保守康复治疗进行病情控制。然而保守治疗无法获得理想疗效，导致很多冻结肩患者迁延不愈。原发性冻结肩病因还没有明确，开放手术松解与关节镜下关节囊松解等属于常用手术治疗方法。比如在……