肱骨骺端减压联合肩周软组织综合处理治疗重度肩痛

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1、肱骨骺端减压联合肩周软组织综合处理治疗重度肩痛荣雪芹1李木田2（1江苏省徐州肿瘤医院疼痛康复科<肿瘤门诊五楼>221002;2江苏省邳州市议堂医院221316）【摘要】目的评价肱骨骺端减压治疗重度肩痛疗效。方法将120例顽固性肩痛患者（采取常规保守疗法无效）随机分为2组：对照组（简称软组织治疗组）仅给予：肩周软组织治疗（肩部各功能肌群等软组织），根据病情不同需要采用痛点和神经阻滞、射频或银质针松解粘连或挛缩组织、物理疗法（肩关节松动术、肩部软组织手法和牵伸训练、各种理疗）等综合肩关节康复方法，实验组即骨骺减压组,病人给予肩周软组织治疗等综合康复方法，并行

2、肱骨骨骺端减压,以VAS疼痛视觉模拟评分法及改良＞评分及肩关节ROM改善程度来评定疗效。结果骨骺减压组经肩周软组织松解联合肱骨骺端减压治疗重度肩痛后，第一天夜间可见疼痛缓解，VAS评分下降显著，治疗后1、2、3周ROM功能改善，而对照组肩痛及肩关节ROM改善弱于实验组。结论肩周软组织松解联合肱骨骺端减压可以治疗重度肩痛，迅速缓解疼痛改善肩关节功能，病程缩短，可以解决难治性肩痛，疗效突出。【关键词】重度肩痛无血管性坏死肩关节各功能肌群肱骨骺端骨骺减压【中图分类号】R493【文献标识码】A【文章编号】1672-5085（2013）39-0028-02[Abstract]

3、Purpose:ToevaluatethedecompressionofbrachialepiphysealsideintheefficacytreatmentofrefractoryseriousShoulderPain.Methodology:120patientswithrefractoryseriousShoulderPain（theconventional/conservativetreatmenthasbeentakenbutinvalid）wererandomlydividedintotwogroups.Namely,controlgroup（refe

4、rredtoasthesofttissuetreatmentgroup）:shouldersofttissuetherapy(shouldermusclesandothersofttissuefunction),accordingtodifferentneedsofthediseasepainpointsandnerveblock,RadioRrequency(RF)orsilverneedlelyses’ofadhesionsorcontractureorganizations,physicaltherapy(jointmobilization,sho

5、uldersofttissuetechniquesanddraftingtraining,avarietyoftreatments)andgrouptherapyshouldersofttissuehumeralepiphysissidedecompressiongroup(referredtoastheepiphysisdecompressiongroup),toassessandimprovetheefficacyofVASpainvisualanalogscale)scoreandshoulderROMimprovement.2.experimentalgro

6、up(epiphysisdecompressiongroup)shouldersofttissuereleasejointbrachialepiphysisendofdecompressiontreatmentofseriousShoulderPainafterthefirstdayofthevisiblenightpainrelief.VASscoredecreasedsignificantly,treatment1,4,8weeksaftershoulderpaindisappearedandROMfunctionimproved,moreeffective.I

7、nconclusion,shouldersofttissuereleasejointthebrachialepiphysealendofdecompressioncantreatseriousShoulderPain,quicklyrelievepainandimproveshoulderfunction,simpleandeffective.【Keywords】seriousShoulderPain(adhesivecapsulitis)AvascularnecrosisFunctionalmuscleofshouldersBrachialepiphyseal