Therapeutic observation of arthrolysis under brachial plexus anesthesia for adhesive capsulitis of the shoulder

Abstract

Objective

To objectively evaluate the short-term and long-term efficacies of arthrolysis under brachial plexus anesthesia in treating adhesive capsulitis of the shoulder (ACS).

Methods

One hundred patients diagnosed with ACS were divided into two groups using the random number method. The two groups both received same active rehabilitation exercises. Besides, 55 cases in the treatment group were given one session of arthrolysis under brachial plexus anesthesia, and 45 cases in the control group were given tuina treatment. Changes in the visual analog scale (VAS) score, Melle score and pressure pain index were observed 1 month and 3 months after treatment. The therapeutic efficacies were also compared.

Results

The total effective rate was 96.4% at the 1-month follow-up and 96.4% at the 3-month follow-up in the treatment group. The total effective rate was 33.3% at the 1-month follow-up and 28.9% at the 3-month follow-up in the control group. There were significant differences between the two groups comparing the total effective rate at the two time points (both Ps<0.05). The scores of VAS, Melle and pressure pain were significantly different at the 1-month and 3-month follow-ups from those before treatment in the treatment group (all Ps<0.05); the three scores did not show significant differences at the 1-month and 3-month follow-ups compared with those before treatment in the control group (all Ps>0.05).

Conclusion

Based on the active rehabilitation exercises, one session of arthrolysis under brachial plexus anesthesia can release the adhesion and restore the range of motion and function of shoulder joint in ACS patients. It is superior to rehabilitation exercises plus tuina treatment comparing both short-term and long-term efficacies.

摘要

目的

对臂丛神经麻醉下手法松解术治疗粘连型肩周炎的近远期疗效进行客观评定。

方法

将100例确 诊为粘连型肩周炎的患者采用随机数字表法分为2组。两组均进行相同的主动康复锻炼, 此外, 治疗组55例加一 次臂丛神经麻醉下手法松解治疗, 对照组45例加用推拿手法治疗。观察治疗后1个月及3个月视觉模拟量表(VAS) 和Melle量表评分及压痛指数变化, 并进行疗效比较。

结果

治疗组1个月后随访时总有效率为96.4%, 3个月后随 访时总有效率为96.4%; 对照组1个月后随访时总有效率为33.3%, 3个月后随访时总有效率为28.9%。两组两个时间 点总有效率差异均有统计学意义(均P<0.05)。在VAS、Melle及压痛指数评分方面, 治疗组1个月和3个月后随访, 均与治疗前具有统计学差异(均P<0.05); 而对照组3个项目评分在治疗后1个月和3个月随访时与治疗前均无统计 学差异(均P>0.05)。

结论

在主动康复锻炼基础上加用一次臂丛神经麻醉下手法松解术能解除粘连型肩周炎患者 的肩关节粘连, 恢复肩关节活动度和功能, 其近期和远期疗效均优于康复锻炼加推拿治疗。