超声引导下曲安奈德注射治疗脑卒中后偏瘫肩痛患者急性肩峰-三角肌下滑囊病变的临床研究

Effectiveness of ultrasound-guided subacromial bursa injection of triamcinolone acetonide in treatment of subacromial bursitis with strokeFan Liu-bo1 Liu Bao-hua2Han Wen-sheng1

摘要:

目的 评价超声引导下曲安奈德注射治疗脑卒中后偏瘫肩痛患者急性肩峰-三角肌下滑囊炎(subacromial-subdeltoid bursa,SASD)的临床疗效。方法：选取2017年１0月-2018年9月在浙江省台州医院康复医学科住院治疗的脑卒中后偏瘫肩痛患者50例,经双侧肩关节超声检查提示肩峰-三角肌下滑囊病变,随机分为治疗组和对照组各25例,治疗组行超声引导下肩峰下滑囊注射治疗,对照组患者采取常规康复治疗,2组患者分别于治疗前与治疗1周、4周后均进行视觉模拟疼痛评分(VAS)、肩SPADI评分及Barthel指数(BI)评定分析。结果：治疗前试验组与对照组 VAS 、SPADI评分及Barthel指数评分比较,差异无统计学意义(P＞0.05)；对照组在1周的VAS、SPADI及BI无明显变化(P＞0.05),2组患者治疗后4周,VAS 评分、SPADI评分及Barthel指数评分均较治疗前明显改善(P＜0.05)。治疗后 4 周,治疗组 VAS评分及SPADI评分明显低于对照组(P＜0.05),治疗组Barthel指数评分明显高于对照组(P＜0.05)。结论：超声引导下肩峰下滑囊内曲安奈德注射可有效治疗脑卒中偏瘫侧SASD病变,能够明显缓解脑卒中后偏瘫侧肩痛,改善肩关节活动范围,提高脑卒中患者日常生活活动能力,其疗效优于常规康复训练方法。

Abstract:

Objective To evaluate the effectiveness of ultrasound-guided (US-guided) subacromial bursa injection of btriamcinolone acetonide in treatment of subacromial bursitis with stroke.Method A total of 50 patients who were diagnosed as subacromial bursitis by ultrasound and then decided to performed US-guided subacromial bursa injection were randomly divided into two groups. The study group was treated with triamcinolone acetonide in treatment, and the control group was treated only with rehabilitation therapy training. Visual analogue score (VAS) 、Shoulder Pain and Disability Index(SPADI) and Barthel index (BI) score were observed before treatment, 1 week and 4 weeks post-treatment during. Result There was no difference of both VAS score、SPADI score and BI score between the control group at 1 week post treatment (both P＞0.05). There were signifi cantly decreased in VAS score 、SPADI score and BI score at 4 weeks post treatment for both groups (both P＜0.05). But at 4 weeks post treatment, the VAS scored and SPADI score of the study group was signifi cantly lower than that of the control group (P＜0.05), while the BI score of the study group was signifi cantly higher than that of the control group (P＜0.05).Conclusion Ultrasound-guided subacromial bursa injection of riamcinolone acetonide is effective in treating subacromial bursitis.It produces better pain and active abduction functional improvement than rehabilitation therapy training. The recuperative effect of ultrasound-guided subacromial bursa injection of triamcinolone acetonide is superior to either only rehabilitation therapy training.