[1]陈 亮,王 进,吴桂鹏,等.超声引导肩胛上神经脉冲射频结合物理疗法治疗脑卒中后肩关节疼痛的疗效分析 [J].介入放射学杂志,2022,31(05):495-498.
 CHEN Liang,WANG Jin,WU Guipeng,et al.Ultrasound-guided suprascapular nerve pulsed radiofrequency combined with physical therapy for the treatment of shoulder joint pain after a stroke: analysis of its curative effect[J].journal interventional radiology,2022,31(05):495-498.
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超声引导肩胛上神经脉冲射频结合物理疗法治疗脑卒中后肩关节疼痛的疗效分析
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
31
期数:
2022年05
页码:
495-498
栏目:
临床研究
出版日期:
2022-07-19

文章信息/Info

Title:
Ultrasound-guided suprascapular nerve pulsed radiofrequency combined with physical therapy for the treatment of shoulder joint pain after a stroke: analysis of its curative effect
作者:
陈 亮 王 进 吴桂鹏 史传岗 倪雪君
Author(s):
CHEN Liang WANG Jin WU Guipeng SHI Chuangang NI Xuejun.
Department of Pain, Affiliated Hai’an Hospital of Nantong University, Nantong, Jiangsu Province 226600, China
关键词:
【关键词】 脉冲射频肩胛上神经肩关节痛脑卒中
文献标志码:
A
摘要:
【摘要】 目的 观察超声引导肩胛上神经脉冲射频(PRF)联合物理疗法治疗脑卒中后肩关节疼痛的疗效。方法 招募90例脑卒中后偏瘫侧肩关节疼痛患者。随机分为肩胛上神经PRF组(n=45)和肩胛上神经阻滞组(n=45)。PRF组接受超声引导下肩胛上神经脉冲神经治疗,神经阻滞组接受超声引导下的肩胛上神经阻滞。两组患者均接受肩部物理治疗(热敷、肩带和肩胸肌的伸展和加强训练)作为辅助治疗。分别于术前,术后第1天、术后1周、1个月、3个月和6个月收集疼痛视觉模拟评分(VAS)、镇痛药物的消耗剂量以及肩关节活动度(ROM)等参数。结果 术后3个月两组疼痛VAS评分均显著降低(P<0.05),但PRF组VAS评分降低幅度较神经阻滞显著。术后6个月,PRF组疼痛VAS评分显著低于术前(P<0.01),而神经阻滞组VAS评分恢复至术前水平(P>0.05);术后6个月各随访时间段PRF组的对乙酰氨基酚的使用剂量显著低于神经阻滞组(P>0.05)。术后1、3和6个月PRF组偏瘫侧肩关节活动度与术前相比显著增高(P<0.05),神经阻滞组与术前比较无显著改变(P>0.05)。结论 超声引导肩胛上神经PRF结合物理疗法是治疗脑卒中后肩关节疼痛的安全有效疗法。

参考文献/References:

[1] Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics- 2015 update: a report from the American Heart Association[J]. Circulation, 2015, 131:e29- e322.
[2] Adey- Wakeling Z, Liu E, Crotty M, et al. Hemiplegic shoulder pain reduces quality of life after acute stroke: a prospective population- based study[J]. Am J Phys Med Rehabil, 2016, 95:758- 763.
[3] Nadler M, Pauls M. Shoulder orthoses for the prevention and reduction of hemiplegic shoulder pain and subluxation: systematic review[J]. Clin Rehabil, 2017, 31:444- 453.
[4] 杨月华,符 建,徐小青,等. 超声引导下肩胛上神经脉冲射频与神经阻滞治疗慢性顽固性肩周痛的疗效分析[J]. 介入放射学杂志, 2018, 27:665- 668.
[5] Huang RY, Liao CC, Tsai SY, et al. Rapid and delayed effects of pulsed radiofrequency on neuropathic pain: electrop-hysiological, molecular, and behavioral evidence supporting long- term depression[J]. Pain Physician, 2017, 20:E269- E283.
[6] Krishnan K,Muthuraj K,Nandhini K,et al. Role of fluoxetine in pharmacological enhancement of motor functions in stroke patients: a randomized, placebo- controlled, single- blind trial[J]. Contemp Clin Trials Commun, 2021, 23:100800.
[7] Cole BF,Peters KS,Hackett L,et al. Ultrasound- guided versus blind subacromial corticosteroid injections for subacromial impingement syndrome: a randomized, double blind clinical trial[J]. Am J Sport Med, 2016, 44:702- 707.
[8] Tahran O, Yesilyaprak SS. Effects of modified posterior shoulder stretching exercises on shoulder mobility, pain, and dysfunction in patients with subacromial impingement syndrome[J]. Sports Health, 2020, 12:139- 148.
[9] Wilson RD, Chae J. Hemiplegic shoulder pain[J]. Phys Med Rehabil Clin N Am, 2015, 26:641- 655.
[10] Sundboll J, Darvalics B, Horvath- Puho E, et al. Preadmission use of glucocorticoids and risk of cardiovascular events in patients with ischemic stroke[J]. J Thromb Haemost, 2018 ,16:2175- 2183.
[11] Terlemez R, Ciftci S, Topaloglu M, et al. Suprascapular nerve block in hemiplegic shoulder pain: comparison of the effectiveness of placebo, local anesthetic, and corticosteroid injections:
a randomized controlled study[J]. Neurol Sci, 2020, 41: 3243- 3247.
[12] Sinha P, Sarkar B, Goswami S, et al. Effectiveness of combination of ultrasonography- guided pulsed radiofrequency neuromo-dulation with steroid at the suprascapular nerve in chronic shoulder pain[J]. Pain Pract, 2020, 20:16- 23.
[13] Orhurhu V, Akinola O, Grandhi R, et al. Radiofrequency ablation for management of shoulder pain[J]. Curr Pain Headache Rep,2019, 23:56.
[14] Chang KV, Wu WT, Hung CY, et al. Comparative effectiveness of suprascapular nerve block in the relief of acute post- operative shoulder pain: a systematic review and meta- analysis[J]. Pain Physician, 2016, 19:445- 456.

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备注/Memo

备注/Memo:
(收稿日期:2021- 05- 03)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2022-07-19