超声引导肩胛上神经联合腋神经阻滞治疗粘连性肩关节囊炎的临床观察

CLINICAL OBSERVATION OF ULTRASOUND-GUIDED SUPRASCAPULAR NERVE AND AXILLARY NERVE BLOCK IN THT TREATMENT OF ADHESIVE SHOULDER CAPSULTIS

摘要:

目的：本研究的目的是明确肩胛上神经阻滞联合腋神经阻滞在对粘连性肩关节囊炎的疼痛强度、活动能力、残疾和生活质量的影响。材料和方法：在2022年1月至2022年12月期间，100名肩周痛患者被纳入本研究,随机分为两组:实验组为超声引导下肩胛上联合腋神经阻滞组（SSAX组），对照组为超声引导下肩胛上神经阻滞组（SSNB组）。在干预前和干预后1周、2周、1月、3月利用VAS、SPADI、SF-36和肩关节活动范围（ROM）进行评估，还要评估治疗后半小时的VAS和被动肩关节ROM。结果：每组50名患者，在组内，SPADI和VAS评分降低，而被动ROM以及SF-36的评分随着时间的推移而增加（P<0.05）。在组间，VAS值和治疗后半小时被动屈曲、外展、外旋的变化在SSAX组中更为显著（P<0.05），第3月的结果测量之间没有显著差异（P>0.05）。结论：超声引导肩胛上神经联合腋神经的组合治疗粘连型肩关节囊炎疗效显著，能够明显改善患者关节功能，提高关节活动度，缓解疼痛，其在治疗后可达到即时缓解疼痛和改善肩关节活动功能的作用。

Abstract:

Objective: The aim of this study was to evaluate the effects of the combination of suprascapular nerve block (SSNB) and axillary nerve block on pain, shoulder range of motion (ROM), disability, and quality of life in the management of patients with adhesive capsulitis. Methods: A total of 100 patients from January 2022 to December 2022 who were diagnosed with adhesive capsulitis were randomly assigned to two groups: SSAX group received SSNB and axillary nerve block combination, while control group only-SSNB. The Shoulder Pain and Disability Index (SPADI),Visual analog scored(VAS), passive shoulder ROMs and the Short Form 36(SF-36) were assessed at baseline and one week,two weeks, one month,three months, and twelve months. The VAS and shoulder ROMs were also examined in the half-hour. Results:Fifty patients? were included in each group .Within the groups, SPADI and VAS scores were decreased, while passive ROMs and the SF-36 scores were increased by time (P < 0.05). Between the groups, the change in VAS value and passive flexion、abduction and external rotation in the half-hour was more remarkable in SSAX group (P < 0.05). No significant difference between outcome measurements was found at the 3rd month (P > 0.05). Conclusion:The combination of suprascapular nerve block and axillary nerve block(SSAX) in the treatment of adhesive shoulder arthritis can significantly improve the patient’s joint function, improve the range of motion and relieve pain,it has positively affected the immediate pain relief and functional improvement after the intervention.