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中华医学超声杂志（电子版）

中华医学超声杂志（电子版） ›› 2015, Vol. 12 ›› Issue (06) : 494 -498. doi: 10.3877/cma.j.issn.1672-6448.2015.06.015

所属专题： 文献；

肌肉骨骼超声影像学

超声引导下复方倍他米松联合玻璃酸钠注射治疗肩峰下滑囊炎的临床研究
成雪晴1, 卢漫2,†(), 贺凡丁2, 郭璇妍2   
  1. 1. 637000　南充，川北医学院研究生院；610072　成都，电子科技大学?四川省人民医院附属医院超声科
    2. 610072　成都，电子科技大学?四川省人民医院附属医院超声科
  • 收稿日期:2014-12-12 出版日期:2015-06-01
  • 通信作者: 卢漫
  • 基金资助:
    四川省科技厅课题(2013JY0183)

Effectiveness of ultrasound-guided subacromial bursa injection of betamethasone combined with hyaluronate in treatment of subacromial bursitis

Xueqing Cheng1, Man Lu2,†(), Fanding He2, Xuanyan Guo2   

  1. 1. North of Sichuan Medical College, Nanchong 637000, China; Department of Ultrasound, the Sichuan Academy of Medical Sciences & Sichuan Provincial Peoples Hospital, Chengdu 610072, China
    2. Department of Ultrasound, the Sichuan Academy of Medical Sciences & Sichuan Provincial Peoples Hospital, Chengdu 610072, China
  • Received:2014-12-12 Published:2015-06-01
  • Corresponding author: Man Lu
  • About author:
    Corresponding author: Lu Man, Email:
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成雪晴, 卢漫, 贺凡丁, 郭璇妍. 超声引导下复方倍他米松联合玻璃酸钠注射治疗肩峰下滑囊炎的临床研究[J]. 中华医学超声杂志（电子版）, 2015, 12(06): 494-498.

Xueqing Cheng, Man Lu, Fanding He, Xuanyan Guo. Effectiveness of ultrasound-guided subacromial bursa injection of betamethasone combined with hyaluronate in treatment of subacromial bursitis[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(06): 494-498.

目的

评价超声引导下复方倍他米松联合玻璃酸钠注射治疗肩峰下滑囊炎（SAB）的疗效。

方法

收集2013年1月至2014年9月因肩部疼痛于四川省人民医院附属医院超声科就诊的门诊患者200例，将其中72例诊断为单纯性SAB且欲行超声引导下肩峰下滑囊注射治疗的患者纳入本研究，随机分为2组。试验组给予复方倍他米松联合玻璃酸钠注射，对照组给予复方倍他米松注射，所有患者治疗后第1周和第4周进行电话随访，治疗前、后均进行疼痛评分（视觉模拟评分法，VAS）和肩关节主动外展活动度评分。

结果

2组患者治疗后1周和4周，VAS评分及肩关节主动外展活动度评分均较治疗前明显改善（P均<0.05）。治疗后1周，试验组与对照组VAS评分及肩关节主动外展活动度评分比较，差异无统计学意义（P均>0.05）；治疗后4周，试验组VAS评分明显低于对照组（2.08±1.95 vs 3.14±2.0，P<0.05），试验组肩关节主动外展活动度评分明显高于对照组（7.12±2.10 vs 6.11±1.93，P<0.05）。

结论

超声引导下肩峰下滑囊内复方倍他米松联合玻璃酸钠注射可有效治疗SAB，其缓解疼痛及改善肩关节主动外展活动范围的短期疗效优于单一使用复方倍他米松注射治疗。

关键词: 滑囊炎, 超声检查，介入性, 玻璃酸钠, 复方倍他米松
Objective

To evaluate the effectiveness of ultrasound-guided (US-guided) subacromial bursa injection of betamethasone combined with hyaluronate for treatment of subacromial bursitis.

Methods

A total of 72 patients who were diagnosed as subacromial bursitis by ultrasound and then decided to performed US-guided subacromial bursa injection were randomly divided into two groups. The study group was treated with compound betamethasone suspension followed by sodium hyaluronate, and the control group was treated only with compound betamethasone suspension. Visual analogue score (VAS) and the shoulder active abduction range of motion (AAROM) score were observed before treatment, 1 week and 4 weeks post-treatment during 1 month's followed-up.

Results

There were significantly decreased in VAS score and increased in AAROM score at 1 week and 4 weeks post treatment for both groups (both P<0.05). There was no difference of both VAS score and AAROM score between the two groups at 1 week post treatment (both P>0.05). But at 4 weeks post treatment, the VAS score of the study group was significantly lower than that of the control group (2.08±1.95 vs 3.14±2.0, P<0.05), while the AAROM score of the study group was significantly higher than that of the control group (7.12±2.10 vs 6.11±1.93, P<0.05).

Conclusions

Ultrasound-guided subacromial bursa injection of betamethasone combined with hyaluronate is effective in treating subacromial bursitis. It produces better pain and active abduction functional improvement than betamethasone at a short-term follow-up.

Key words: Bursitis, Ultrasonography, interventional, Hyaluronate, Betamethasone
图1 肩峰下滑囊炎超声声像图表现
图2 超声引导下肩峰下滑囊炎注射治疗超声声像图表现
表1 2组肩峰下滑囊炎患者肩关节疼痛评分（VAS评分）结果（±s）
组别 例数 治疗前 治疗后1周 治疗后4周
试验组 36 7.01±1.83 2.99±2.03 2.08±1.95
对照组 36 6.53±1.12 3.0±1.73 3.14±2.0
t值 ? 0.912 -1.470 -2.147
P值 ? 0.339 0.196 0.046
表2 2组肩峰下滑囊炎患者肩关节主动外展活动度评分结果（±s）
组别 例数 治疗前 治疗后1周 治疗后4周
试验组 36 4.50±2.16 6.23±1.99 7.12±2.10
对照组 36 4.33±2.0 5.77±1.99 6.11±1.93
t值 ? 0.198 -0.891 2.156
P值 ? 0.735 0.339 0.043
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