超声引导下水分离术联合托肩松动手法治疗肩周炎粘连期的疗效观察OA
The Therapeutic Effect of Ultrasound-Guided Hydrodissection Combined with Shoulder-Supporting Mobilization Manipulation in the Adhesive Stage of Shoulder Periarthritis
目的:研究超声引导下水分离术联合托肩松动手法治疗肩周炎粘连期的疗效.方法:选取2024年1月~2025年1月收治的肩周炎粘连期患者60例,随机分为对照组和观察组各30例.对照组采用托肩松动手法治疗,观察组采用超声引导下水分离术联合托肩松动手法治疗,对比观察两组患者治疗前及治疗1周、2周、3周后的肩关节Constant-Murley功能评分、超声影像学(腋下盂肱关节囊厚度、喙肱韧带厚度、肩峰-三角肌下滑囊厚度、肩袖肌腱弹性剪切波均值)、肩关节软组织红外线热像图色码温度值.结果:CMS评分、肩关节软组织厚度(腋下盂肱关节囊厚度、喙肱韧带厚度、肩峰-三角肌下滑囊厚度)、肩袖肌腱弹性剪切波均值、肩关节软组织红外线热像图色码温度值组别与时间均存在交互作用(P交互<0.01).治疗1周、2周、3周后,两组患者CMS评分、肩关节软组织红外线热像图色码温度值均比治疗前升高(均P<0.05),肩关节软组织厚度(腋下盂肱关节囊厚度、喙肱韧带厚度、肩峰-三角肌下滑囊厚度)、肩袖肌腱弹性剪切波均值均比治疗前降低(P<0.05).且观察组各时间点CMS评分高于同期对照组(P<0.05),各时间点肩关节软组织厚度(腋下盂肱关节囊厚度、喙肱韧带厚度、肩峰-三角肌下滑囊厚度)、肩袖肌腱弹性剪切波均值均低于同期对照组(P<0.05).治疗2周、3周后,观察组肩关节软组织红外线热像图色码温度值均高于同期对照组(P<0.05).结论:超声引导下水分离术联合托肩松动手法可提高Constant-Murley功能评分,降低腋下盂肱关节囊、喙肱韧带、肩峰-三角肌下滑囊厚度、肩袖肌腱硬度,提高肩关节软组织温度.
Objective:To study the efficacy of ultrasound-guided hydrodissection combined with shoulder-supporting mobilization manipulation in the treatment of shoulder periarthritis in the adhesive stage.Methods:Sixty patients with shoulder periarthritis in the adhesive stage admitted from January 2024 to January 2025 were randomly divided into a control group and an observation group,with 30 patients in each group.The control group was treated with shoulder-supporting mobilization manipulation,while the observation group was treated with ultrasound-guided hydrodissection combined with shoulder-supporting mobilization manipulation.The Constant-Murley score(CMS),ultrasound imaging findings(axillary glenohumeral joint capsule thickness,coracohumeral ligament thickness,subacromial-subdeltoid bursa thickness,and mean shear-wave elastography value of the rotator cuff tendon),and color-code temperature values of shoulder soft tissue on infrared thermography were compared between the two groups before treatment and after 1,2,and 3 weeks of treatment.Results:Significant group×time interactions were found for the CMS score,shoulder soft tissue thickness(axillary glenohumeral joint capsule thickness,coracohumeral ligament thickness,subacromial-subdeltoid bursa thickness),mean shear-wave elastography value of the rotator cuff tendon,and color-code temperature values of shoulder soft tissue on infrared thermography(P interaction<0.01).After 1,2,and 3 weeks of treatment,the CMS scores and the color-code temperature values of shoulder soft tissue on infrared thermography in both groups increased compared to before treatment(P<0.05),while the shoulder soft tissue thickness and the mean shear-wave elastography value of the rotator cuff tendon decreased(P<0.05).Moreover,the CMS scores of the observation group at each time point were higher than those of the control group at the same time point(P<0.05),and the shoulder soft tissue thickness and the mean shear-wave elastography value of the rotator cuff tendon were lower than those of the control group at the same time point(P<0.05).After 2 and 3 weeks of treatment,the color-code temperature values of shoulder soft tissue on infrared thermography in the observation group were higher than those in the control group during the same period(P<0.05).Conclusion:Ultrasound-guided hydrodissection combined with shoulder-supporting mobilization manipulation can improve the Constant-Murley score,reduce the thickness of the axillary glenohumeral joint capsule,coracohumeral ligament,and subacromial-subdeltoid bursa,reduce rotator cuff tendon stiffness,and increase the temperature of shoulder soft tissue.
龙毅;李晓静;曾启明;阎晋南;高崇阳
云南中医药大学第一附属医院,云南 昆明 650021昆明市妇幼保健院,云南 昆明 650031昆明市中医医院,云南 昆明 650011云南中医药大学第一附属医院,云南 昆明 650021云南中医药大学第一附属医院,云南 昆明 650021
医药卫生
肩周炎粘连期超声肩关节注射托肩松动手法组织厚度红外线热像图
scapulohumeral periarthritisadhesive stageultrasoundshoulder joint injectionshoulder-supporting mobilization manipulationtissue thicknessinfrared thermography
《中医康复》 2026 (10)
52-58,7
云南中医药大学校院联合基金项目(XYLH2023112)
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