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目的:观察分析关节镜下关节囊松解术结合局部注射治疗原发性冻结肩的临床疗效。方法:自2012年12月-2013年6月对保守治疗4个月以上无效的原发性冻结肩患者30例进行临床治疗。患者随机分为2组,对照组仅在关节镜下行关节囊松解术,试验组术后2 d于盂肱关节及肩峰下滑囊注射肾上腺糖皮质激素加局麻药,2组均系统指导其康复训练,随访6个月以上。分别于术前、术后2周、1月、3月采用Constant肩关节功能评分法进行肩关节功能评估。结果:所有患者术前、术后肩关节功能评分对比有统计学意义(P<0.05);两组间患者术前及术后3月肩关节功能评分差异无统计学意义(P>0.05);术后2周、1月时,试验组肩关节功能评分均高于对照组,差异均有统计学意义(P<0.05)。结论:1关节镜下肩关节囊松解术能有效治疗原发性冻结肩。2术后结合局部注射治疗的近期疗效优于单纯手术治疗,能更明显改善患者肩关节功能,提高患者康复训练依从性。
OBJECTIVE: To observe the clinical effect of arthroscopic debridement combined with local injection in the treatment of primary frozen shoulder. Methods: From December 2012 to June 2013, 30 cases of primary frozen shoulder patients who were treated conservatively for more than 4 months were treated clinically. The patients were randomly divided into two groups. The control group underwent arthrodesis only under arthroscopy. The experimental group was given gonadal corticosteroids plus local anesthesia on the glenohumeral joint and acromiocervical sac two days after operation, and the two groups were systematically instructed Rehabilitation training, follow-up more than 6 months. Shoulder joint functional assessment was performed using the Constant Shoulder Function Scale at preoperative, postoperative 2 weeks, January, and March respectively. Results: The score of shoulder joint function before and after operation in all patients was statistically significant (P <0.05). There was no significant difference in shoulder function scores between the two groups before and after operation in 3 months (P> 0.05). At 2 weeks and 1 month after operation, the functional scores of shoulder joint in the experimental group were significantly higher than those in the control group (P <0.05). Conclusions: 1 arthroscopic shoulder capsule lysis can effectively treat the primary frozen shoulder. 2 postoperative combination of local injection and treatment of short-term effect is better than surgery alone, can significantly improve the patient’s shoulder function, improve patient compliance training rehabilitation.