肩关节镜下盂肱关节前方松解术与保守疗法治疗冻结肩的疗效与安全性比较

Comparison of efficacy and safety between arthroscopic anterior glenohumeral joint release and conservative treatment for frozen shoulder

摘要:

目的 比较肩关节镜下盂肱关节前方松解术与保守疗法治疗冻结肩的疗效和安全性。方法 前瞻性选取2021年10月－2022年10月该院收治的98例冻结肩患者作为研究对象，随机分为A组和B组，A组48例患者采用肩关节镜下盂肱关节前方松解术治疗，B组50例患者采用保守治疗。比较两组患者治疗效果、不同时点肩关节功能评分、肩关节活动度、视觉模拟评分法（VAS）、肩关节主动活动范围（AROM）评分、匹兹堡睡眠质量指数（PSQI）和并发症发生情况。结果 A组临床治疗总有效率为93.75%（45/48），明显高于B组的76.00%（38/50）；治疗3个月后，A组肩关节功能评分明显高于B组，两组患者前屈、内旋、外展和外旋活动度较治疗前增加，且A组大于B组，A组VAS和PSQI明显低于B组，AROM评分高于B组，差异均有统计学意义（P < 0.05）。结论 与保守疗法相比，肩关节镜下盂肱关节前方松解术治疗冻结肩，临床效果更好，能够明显改善患者肩关节功能和活动度等情况，减轻关节疼痛，提高睡眠质量，且无明显的并发症发生，值得临床推广应用。

Abstract:

Objective To explore the difference of efficacy and safety between arthroscopic anterior glenohumeral joint release and conservative treatment for frozen shoulder.Methods 98 patients with frozen shoulder from October 2021 to October 2022 were prospectively selected as the study subjects. They were randomly divided into group A and group B. 48 patients in group A were treated with anterior glenohumeral joint release under shoulder arthroscopy, and 50 patients in group B were treated conservatively. The clinical effects of the two groups were compared. The Constant-Murley shoulder function score, shoulder range of motion, visual analogue scale (VAS), active range of motion (AROM) score and Pittsburgh sleep quality index (PSQI) were compared before and after treatment in the two groups, and the complications of the two groups were observed.Result The total effective rate of clinical treatment in group A was 93.75% (45/48), which was significantly higher than that in group B 76.00% (38/50); After 3 months of treatment, the shoulder joint function score of group A was higher than that of group B, the activity indexes of flexion, internal rotation, abduction and external rotation in two groups were increased after treatment, and group A was higher than group B, VAS and PSQI scores were lower and AROM scores was higher in group A than in group B, the differences were statistically significant (P < 0.05).Conclusion The anterior glenohumeral joint release under arthroscopy has a better therapeutic effect on patients with frozen shoulder than conservative treatment. It can significantly improve the function and activity of the shoulder joint, reduce joint pain, improve sleep quality, and has no significant complications. It is worthy of clinical reference.