多次超声引导下肩袖间隙糖皮质激素注射治疗疼痛期粘连性肩关节囊炎的短期疗效优于后路盂肱关节腔注射

Mutiple ultrasound-guided rotator interval corticosteroid injection is better than posterior intra-articular injection for adhesive capsulitis of shoulder in the pain stage

摘要:

摘要 目的：比较超声引导下肩袖间隙(rotator interval, RI)与后路盂肱关节腔(intra-articular, IA) 糖皮质激素注射治疗疼痛期粘连性肩关节囊炎（frozen shoulder, FS）的疗效。方法：从2019年6月至2021年3月来我科就诊确诊为粘连性肩关节囊炎的患者中选取80例，随机分成两组，每组各40例，RI组接受3次超声引导下RI糖皮质激素注射，IA组接受3次超声引导下IA注射。比较两组治疗前、治疗后4周、8周和12周时疼痛的数字模拟评分(Numeric rating scale, NRS)、肩关节疼痛与功能障碍指数（shoulder pain and disability index, SPADI）和肩关节主动活动范围（active range of motion, AROM），同时比较两组的平均操作时间。结果 与治疗前相比，治疗后各随访时间点两组患者的NRS、SPADI和AROM均显著改善（P＜0.05）；组间比较时，RI组以上各项指标的改善情况则更优于IA组( P＜0.05)，且RI组平均操作时间明显短于IA组（P＜0.05）。 结论 对于疼痛期粘连性肩关节囊炎患者，超声引导下RI糖皮质激素注射比后路IA注射短期疗效更佳，且操作更为便捷。

Abstract:

Abstract Objective To compare the effectiveness of ultrasound-guided rotator interval and posterior intra-articular corticosteroid injection for adhesive capsulitis of shoulder in the pain stage. Methods 80 patients diagnosed as adhesive capsulitis of shoulder at our pain department from April, 2019 to March, 2021 were randomized to two equal groups. Patients in RI group received three ultrasound-guided RI corticosteroid injections while patients in IA group received three IA injections. Pain assessed by numeric rating scale (NRS), shoulder pain and disability index (SPADI), and active range of motion (AROM) of patients in both groups at baseline, post-injection week 4, week 8 and week 12 were compared. The average operating time was also compared. Results At all the follow-up times after treatment, both groups showed signicant improvement regarding NRS, SPADI and AROM compared with baseline ( P＜0.05). RI group showed a statistically significant higher level of improvement regarding NRS, SPASDI, and AROM compared to IA group. The average operating time in RI group was shorter significantly than that in IA group( P＜0.05). Conclusion To treat frozen shoulder adhesive capsulitis of shoulder in the pain stage with corticosteroid injection, RI injection yielded better short-term effects than IA injection. Moreover, RI injection is quicker and more convenient