| 麻醉下手法松解配合关节镜技术治疗原发性冻结肩 |
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投稿时间：2011-04-10
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| 作者 | Author | 单位 | Address | E-Mail |
| 孙晋 |
SUN Jin |
中国中医科学院望京医院关节镜及运动医学科，北京 100700 |
Department of Arthroscopy and Athletic Medicine,Wangjing Hospital,China Academy of Chinese Medical Science, Beijing 100700,China |
sunasiasun@163.com |
| 张磊 |
ZHANG Lei |
中国中医科学院望京医院关节镜及运动医学科，北京 100700 |
Department of Arthroscopy and Athletic Medicine,Wangjing Hospital,China Academy of Chinese Medical Science, Beijing 100700,China |
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| 刘劲松 |
LIU Jin-song |
中国中医科学院望京医院关节镜及运动医学科，北京 100700 |
Department of Arthroscopy and Athletic Medicine,Wangjing Hospital,China Academy of Chinese Medical Science, Beijing 100700,China |
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| 马佳 |
MA Jia |
中国中医科学院望京医院关节镜及运动医学科，北京 100700 |
Department of Arthroscopy and Athletic Medicine,Wangjing Hospital,China Academy of Chinese Medical Science, Beijing 100700,China |
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| 李智尧 |
LI Zhi-yao |
中国中医科学院望京医院关节镜及运动医学科，北京 100700 |
Department of Arthroscopy and Athletic Medicine,Wangjing Hospital,China Academy of Chinese Medical Science, Beijing 100700,China |
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| 期刊信息：《中国骨伤》2011年，第24卷，第6期，第490-492页 |
| DOI：10.3969/j.issn.1003-0034.2011.06.015 |
| 基金项目: |
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中文摘要:
目的：探讨麻醉下手法松解配合关节镜技术治疗原发性冻结肩的可行性及疗效。
方法：2006年1月至2009年3月，原发性冻结肩僵硬期患者共34例，均经保守治疗无效，其中男20例，女14例；年龄43～62岁，平均(56±3.6)岁；病程9～13个月，平均11.3个月。全麻下先行盂肱关节、肩峰下间隙清理，再行麻醉下手法松解后镜下射频修整止血及进行针对性松解。术后第1天即开始行患肩主动、被动功能练习，术后所有患者得到随访，平均18.9个月(13～32个月),对治疗前后患者疼痛、关节活动度Constant评分进行对比分析。
结果：术后12个月患肩Constant疼痛评分(总分15分)为(13±1.58)分，较术前的疼痛评分(5±2.60)分降低( P<0.01).34例术后12个月Constant评分(86±11.20)分，比术前(27±2.40)分明显改善(P<0.01).
结论：麻醉下手法松解配合关节镜技术治疗原发性冻结肩功能恢复快，具有疗效确切、微创、恢复快等特点。 |
| 【关键词】肩凝症 手法，骨科 麻醉 关节镜检查 |
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| Treatment of primary frozen shoulder with manipulation under anesthesia combined with arthroscopy |
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ABSTRACT
Objective: To study the feasibility and effectiveness of manipulation under anesthsia combined with arthroscopy for the treatment of primary frozen shoulder.
Methods: Thirty-four patients with primary frozen shoulder were treated from January 2006 to March 2009,including 20 males and 14 females with an average age of(56±3.6) years(ranged from 43 to 62 years). The course of the disease ranged from 9 to 13 months,with a mean time of 11.3 months. All the patient were treated with manipulation under anesthsia combined with arthroscopy. The synovitis of the biceps tendon and the rotator interval was thermo-coagulated,and limited synoviectomy was performed. Subacromial bursoscopy was applied to the patients after glenohumeral arthroscopy. Secondly radiofrequency electrode was used to coagulate bleeding and manipulative relax was performed. All the patients started active and passive postoperative rehabilitation from 1st day after treatment and were followed up for an average of 18.9 months (ranged from 13 to 32 months). The range of motion (ROM) of shoulder joint and feeling of pain calculated by Constant score system were compared before and after the operation.
Results: The post-operative feeling of pain according to Constant score system at 12 months after operation(total 15 points) was (13±1.58),which was different from that of pre-operative score of(5±2.60)(P<0.01). As compared with pre-operative conditions,the motion of shoulder revealed significant improvement at different postoperative stages(P<0.05). The total post-operative score according to Constant score system at 12 months after operation was(86±11.20),which was higher than that of pre-operative score of(27±2.40)(P<0.01).
Conclusion: Manipulation under anesthsia combined with arthroscopy is an effective,optimal,minimal invasive management with high clinical value for primary frozen shoulder. |
| KEY WORDS Frozen shoulder Manipulation,orthopedic Anesthsia Arthroscopy |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 孙晋,张磊,刘劲松,马佳,李智尧.麻醉下手法松解配合关节镜技术治疗原发性冻结肩[J].中国骨伤,2011,24(6):490~492 |
| 英文格式: | SUN Jin,ZHANG Lei,LIU Jin-song,MA Jia,LI Zhi-yao.Treatment of primary frozen shoulder with manipulation under anesthesia combined with arthroscopy[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(6):490~492 |
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