目的:探讨高频超声对全麻下行松解手法治疗重症肩凝症的疗效评估。方法:应用高频超声对153例重症肩凝症患者行陆氏松解手法术前顺序检查肱二头肌肌腱、肩胛下肌腱、冈上肌腱和冈下肌腱,记录超声图像,对肩凝症各组肌腱病变做出诊断,根据超声图像将肩周炎进行分型,各种病变可同时存在于一侧患肩,肩峰撞击征及喙突撞击征阳性者,测量肱骨大结节与肩峰距离以及肱骨小结节与喙突距离,并与对侧比较,松解术后复查超声,通过测量肱骨大结节与肩峰距离以及肱骨小结节与喙突距离来评估其疗效。结果:在全麻下实行陆氏松解手法术前术后进行超声检查,测量肩峰与肱骨大结节之间的距离、喙突与肱骨小结节之间距离与术前比较差异有统计学意义(P〈0.05),临床效果明显,且无并发症出现。结论:高频超声无创、便于检查,可动态观察肩关节各组肌腱,为术前进行诊断,术后评估疗效提供了影像学依据。
Objective:To discuss high frequency ultrasound on severe Frozen Shoulder and the therapy effect of shoulderloosening technique under general anesthesia.Methods:Practice Lu's shoulder-loosening technique on 153 frozen shoulder patient with the help of high frequency ultrasound.Before the operation the biceps tendon,subscapularis tendon,supraspinatus tendon and infraspinatus tendon were examined and the ultrasound images were recorded.And then a diagnose of tendinopathy of the frozen shoulders were made.They were divided into different types according to the ultrasound image.One patient may have different kinds of symptoms.The distance between the humeral greater tuberosity and the acromion as well as the small nodules and the coracoid of positive cases of coracoid impingement syndrome and impingement signs were measured.The result were compared with the other side.After the operation were another ultrasound exam made.The therapy effect were valued by measuring the distance between the humeral greater tuberosity and the acromion as well as the small nodules and the coracoid.Results:Making ultrasound exam in Lu's shoulder-loosening technique under general anesthesia and measuring the distance between the humeral greater tuberosity and the acromion as well as the small nodules and the coracoid.The results are obviously different from those before the operation(P〈0.05).The clinical effect is obvious,and there are no complications.Conclusion:High frequency ultrasound is noninvasive,and it is convenient for the exam.It can observe different groups of tendons.It provides the image evidence of diagnose before the operation and the assessment of therapy effect after the operation.