关节松动术及超短波联合体外冲击波治疗肩周炎的疗效观察
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摘要
目的观察关节松动术及超短波联合体外冲击波治疗肩周炎的临床效果,为临床治疗肩周炎患者的方法选择提供参考依据。方法选取2016年1月～2018年1月我院康复科门诊收治的肩周炎患者62例,随机分为观察组和对照组,每组31例。对照组采用关节松动及超短波治疗,观察组在对照组基础上加用体外冲击波治疗。比较两组患者治疗前后肩关节活动度(ROM)、患者的疼痛程度视觉模拟评分(VAS)及临床疗效。结果治疗后观察组ROM改善程度高于对照组,差异有统计学意义(P<0.05)。治疗后观察组疼痛程度VAS评分低于对照组[(2.03±1.47)分vs (3.26±2.51)分],差异有统计学意义(P<0.05)。治疗后观察组患者的治疗有效率高于对照组(93.54%vs 80.65%),差异有统计学意义(P<0.05)。结论采用关节松动术及超短波联合体外冲击波治疗肩周炎,能明显扩大肩关节活动度,减轻肩关节疼痛,取得了明显的临床疗效。
Objective To observe the clinical effect of joint mobilization and ultrashort wave combined with extracorporeal shock wave in the treatment of frozen shoulder, and provide reference for clinical treatment of patients with frozen shoulder. Methods A total of 62 patients with scapulohumeral periarthritis admitted to our hospital from January 2016 to January 2018 were randomly divided into observation group and control group, with 31 cases in each group. The control group was treated with joint loosening and ultrashort wave therapy, and the observation group was treated with extracorporeal shock wave on the basis of the control group. The shoulder joint mobility(ROM), the patient's pain degree visual analog scale(VAS)and clinical efficacy were compared before and after treatment. Results After treatment, the improvement of ROM in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05). After treatment, the VAS score of the observation group was lower than that of the control group [(2.03 ±1.47) points vs(3.26 ±2.51) points],the difference was statistically significant(P<0.05). After treatment, the treatment efficiency of the observation group was higher than that of the control group(93.54% vs 80.65%),the difference was statistically significant(P<0.05).Conclusion The use of joint mobilization and ultrashort wave combined with extracorporeal shock wave to treat periarthritis of shoulder can significantly expand the mobility of shoulder joint and relieve shoulder pain. The clinical effect has been achieved.
Objective To observe the clinical effect of joint mobilization and ultrashort wave combined with extracorporeal shock wave in the treatment of frozen shoulder, and provide reference for clinical treatment of patients with frozen shoulder. Methods A total of 62 patients with scapulohumeral periarthritis admitted to our hospital from January 2016 to January 2018 were randomly divided into observation group and control group, with 31 cases in each group. The control group was treated with joint loosening and ultrashort wave therapy, and the observation group was treated with extracorporeal shock wave on the basis of the control group. The shoulder joint mobility(ROM), the patient's pain degree visual analog scale(VAS)and clinical efficacy were compared before and after treatment. Results After treatment, the improvement of ROM in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05). After treatment, the VAS score of the observation group was lower than that of the control group [(2.03 ±1.47) points vs(3.26 ±2.51) points],the difference was statistically significant(P<0.05). After treatment, the treatment efficiency of the observation group was higher than that of the control group(93.54% vs 80.65%),the difference was statistically significant(P<0.05).Conclusion The use of joint mobilization and ultrashort wave combined with extracorporeal shock wave to treat periarthritis of shoulder can significantly expand the mobility of shoulder joint and relieve shoulder pain. The clinical effect has been achieved.
引文
[1]左清海.关节松动术结合体外冲击波治疗肩周炎疗效观察[J].深圳中西医结合杂志,2017,27(17):136-137.
[2]吴在德,吴肇汉.外科学[M].第7版.北京:人民卫生出版社,2010:834-835.
[3]Kumar A.A Comparative Study on the Efficacy of Maitland's Mobilization and Muscle Energy Technique on Frozen Shoulder[J].Ind Jour of Physioth and Occupat Therapy-An Inter Jour,2015,9(4):39-43.
[4]Merolla G,Dave AC,Paladini P,et al.Ossifying tendinitis of the rotator cuff after arthroscopic excision of calcium deposits:report of two cases and literature review[J].J Orthop Traumatol,2015,16(1):67-73.
[5]陈勇,彭轩,汤智伟,等.关节松动术结合体外冲击波治疗肩周炎的疗效观察[J].中国康复,2014,29(3):192-194.
[6]Verstraelen FU,In den Kleef NJ,Jansen L,et al.High-energy versus low-energy extracorporeal shock wave therapy for calcifying tendinitis of the shoulder:which is superior?A meta-analysis[J].Clin Orthop Relat Res,2014,472(9):2816-2825.
[7]Alkhawashki HM.Shock wave therapy of fracture nonunion[J].Injury,2015,46(11):2248-2252.
[8]Kim JH,Kim JY,Choi CM,et al.The Dose-Related Effects of Extracorporeal Shock Wave Therapy for Knee Osteoarthritis[J].Ann Rehabil Med,2015,39(4):616-623.
[9]Ioppolo F,Rompe JD,Furia JP,et al.Clinical application of shock wave therapy(SWT)in musculoskeletal disorders[J].Eur JPhys Rehabil Med,2014,50(2):217-230.
[10]张锦,杨红梅.冲击波结合关节松动术治疗肩周炎疗效[J].现代仪器与医疗,2016,22(5):120-122.
[11]Romeo P,Lavanga V,Pagani D,et al.Extracorporeal shockwave therapy in musculoskeletal disorders:a review[J].Med Princ Pract,2014,23(1):7-13.
[12]蔡振宇,林山.体外冲击波治疗肩周炎临床效果观察[J].中国骨科临床与基础研究杂志,2015,7(3):157-161.
[13]刘小敏,姜迪,邓运明,等.体外冲击波治疗肩关节周围炎的疗效观察[J].中华物理医学及康复杂志,2014,36(9):700-701.
[14]徐钢,朱永,赵燕邦,等.体外冲击波治疗肩周炎的效果观察[J].中国当代医药,2016,23(16):77-79.
[15]Louwerens JK,Veltman ES,van Noort A,et al.The Effectiveness of High-Energy Extracorporeal Shockwave Therapy Versus Ultrasound-Guided Needling Versus Arthroscopic Surgery in the Management of Chronic Calcific Rotator Cuff Tendinopathy:A Systematic Review[J].Arthroscopy,2016,32(1):165-175.
[16]Louwerens JK,Sierevelt IN,van Noort A,et al.Evidence for minimally invasive therapies in the managementof chronic calcific tendinopathy of the rotator cuff:a systematic review and meta-analysis[J].J Shoulder Elbow Surg,2014,23(8):1240-1249.
[2]吴在德,吴肇汉.外科学[M].第7版.北京:人民卫生出版社,2010:834-835.
[3]Kumar A.A Comparative Study on the Efficacy of Maitland's Mobilization and Muscle Energy Technique on Frozen Shoulder[J].Ind Jour of Physioth and Occupat Therapy-An Inter Jour,2015,9(4):39-43.
[4]Merolla G,Dave AC,Paladini P,et al.Ossifying tendinitis of the rotator cuff after arthroscopic excision of calcium deposits:report of two cases and literature review[J].J Orthop Traumatol,2015,16(1):67-73.
[5]陈勇,彭轩,汤智伟,等.关节松动术结合体外冲击波治疗肩周炎的疗效观察[J].中国康复,2014,29(3):192-194.
[6]Verstraelen FU,In den Kleef NJ,Jansen L,et al.High-energy versus low-energy extracorporeal shock wave therapy for calcifying tendinitis of the shoulder:which is superior?A meta-analysis[J].Clin Orthop Relat Res,2014,472(9):2816-2825.
[7]Alkhawashki HM.Shock wave therapy of fracture nonunion[J].Injury,2015,46(11):2248-2252.
[8]Kim JH,Kim JY,Choi CM,et al.The Dose-Related Effects of Extracorporeal Shock Wave Therapy for Knee Osteoarthritis[J].Ann Rehabil Med,2015,39(4):616-623.
[9]Ioppolo F,Rompe JD,Furia JP,et al.Clinical application of shock wave therapy(SWT)in musculoskeletal disorders[J].Eur JPhys Rehabil Med,2014,50(2):217-230.
[10]张锦,杨红梅.冲击波结合关节松动术治疗肩周炎疗效[J].现代仪器与医疗,2016,22(5):120-122.
[11]Romeo P,Lavanga V,Pagani D,et al.Extracorporeal shockwave therapy in musculoskeletal disorders:a review[J].Med Princ Pract,2014,23(1):7-13.
[12]蔡振宇,林山.体外冲击波治疗肩周炎临床效果观察[J].中国骨科临床与基础研究杂志,2015,7(3):157-161.
[13]刘小敏,姜迪,邓运明,等.体外冲击波治疗肩关节周围炎的疗效观察[J].中华物理医学及康复杂志,2014,36(9):700-701.
[14]徐钢,朱永,赵燕邦,等.体外冲击波治疗肩周炎的效果观察[J].中国当代医药,2016,23(16):77-79.
[15]Louwerens JK,Veltman ES,van Noort A,et al.The Effectiveness of High-Energy Extracorporeal Shockwave Therapy Versus Ultrasound-Guided Needling Versus Arthroscopic Surgery in the Management of Chronic Calcific Rotator Cuff Tendinopathy:A Systematic Review[J].Arthroscopy,2016,32(1):165-175.
[16]Louwerens JK,Sierevelt IN,van Noort A,et al.Evidence for minimally invasive therapies in the managementof chronic calcific tendinopathy of the rotator cuff:a systematic review and meta-analysis[J].J Shoulder Elbow Surg,2014,23(8):1240-1249.