摘要
目的观察超声引导下肩部神经脉冲射频复合肩袖间隙臭氧注射治疗肩袖损伤的安全性及有效性。方法收集上海交通大学医学院附属苏州九龙医院疼痛科2019年1月至2020年3月就诊的40例肩袖损伤患者,年龄25~68岁,性别不限,采用随机数字表法将其随机分为:超声引导下肩部神经(肩胛上神经、腋神经)脉冲射频复合臭氧注射组(A组)和超声引导下肩部神经(肩胛上神经、腋神经)脉冲射频组(B组),每组20例。脉冲射频参数:42℃,360 s,2次。A组患者射频治疗后,肩袖损伤间隙注射30μg/ml医用臭氧5 ml。观察两组治疗前,治疗后1、12、24、72 h及1、3、6个月时患侧肩的数字模拟评分(VAS)、睡眠时间、主动前屈关节活动度(AFROM)及外展关节活动度(AAROM)的评估。对两组患者治疗前后行肩部核磁共振检查。结果两组患者治疗后VAS评分均较治疗前明显降低,睡眠时间均较治疗前延长,AFROM及AAROM均较治疗前增加,差异均具有统计学意义(P均<0.05);两组VAS评分比较治疗后1 h差异无统计学意义(P>0.05),A组治疗后12 h至治疗后6个月均较B组明显降低(P均<0.05);两组睡眠时间治疗后1 h差异无统计学意义(P>0.05),A组治疗后12 h至治疗后6个月均较B组明显延长(P均<0.05);两组AFROM及AAROM治疗后1 h差异无统计学意义(P均>0.05),治疗后12 h至治疗后6个月时A组较B组明显增加(P均<0.05)。治疗后核磁共振显示A组积液及水肿改善均较B组明显(P均<0.05)。结论超声引导下肩部神经脉冲射频复合肩袖间隙臭氧注射治疗肩袖损伤安全有效,且疗效优于单纯肩部神经脉冲射频治疗。
Objective To observe the safety and efficacy of ultrasound-guided shoulder nerve pulse radiofrequency combined with rotator cuff space ozone injection in the treatment of patients with rotator cuff injury pain.Methods Forty patients with rotator cuff injury,aged 25 to 68 years old,regardless of gender,in the Pain Department of Suzhou Jiulong Hospital from January 2019 to March 2020,were enroll and randomly divided into the following groups by random number table method:the group of ultrasonic guided pulse radiofrequency of shoulder nerve(suprascapular nerve and axillary nerve)combined with ozone injection(group A),and the group of ultrasonic guided pulse radiofrequency of shoulder nerve(suprascapular nerve and axillary nerve)(group B),20 cases in each group.Pulse RF parameters were 42℃,360 s,2 times.In group A,30 g/ml of medical ozone was injected into the rotator cuff injury space after the radiofrequency.Visual analogue scale(VAS),sleeping time,active flexion range of motion(AFROM)and active abduction range of motion(AAROM)of the affected shoulder were evaluated in the two groups before the treatment and 1,12,24,72 hours,and 1,3 and 6 months after the treatment.Magnetic resonance imaging(MRI)of shoulder was performed before and after the treatment in the two groups.Results After the treatment,VAS was significantly lower in the two groups than that before the treatment,ST was longer than that before the treatment,and both the AFROM and AAROM were higher than those before the treatment,with statistically differences(all P<0.05).There was no significant difference of VAS at the time point of 1 hour after the treatment(P>0.05),but at the time points from 12 hours to 6 months after the treatment were significantly lower in group A than those in group B(all P<0.05).There was no significant difference of sleeping time between the two groups at the time point of 1 hour after the treatment(P>0.05),but from 12 hours to 6 months after the treatment were significantly longer in group A than those in group B(all P<0.05).There was no significant difference of AFROM and AAROM at 1 hour after the treatment between the two groups(all P>0.05),but from 12 hours to 6 months after the treatment all of the time points were significantly higher in group A than those in group B(all P<0.05).After the treatment,MRI showed that the improvements of effusion and edema in group A were significantly more obvious than those in group B(all P<0.05).Conclusion Ultrasound guided suprascapular nerve and axillary shoulder nerve pulse radiofrequency combined with rotator cuff space ozone injection is safe and effective in the treatment of patients with rotator cuff injury,and the efficacy is better in the combined method than that in the nerve pulse radiofrequency treatment only.
作者
吴隆延
景璟
高佳斌
郑宝森
Wu Longyan;Jing Jing;Gao Jiabin;Zheng Baosen(Department of Pain Management,Jiulong Hospital,Shanghai Jiaotong University Medical School,Suzhou City,Jiangsu Province 215028,China;Department of Pain Management,Tianjin First Central Hospital,Tianjin City 300192,China)
出处
《中华疼痛学杂志》
2020年第5期394-401,共8页
Chinese Journal Of Painology
关键词
导管消融术
臭氧
肩关节
软组织损伤
Catheter ablation
Ozone
Shoulder joint
Soft tissue injuries
