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蔡桂元,贺涓涓,李 娜,李 鑫,窦祖林,解东风,陈嘉如,姜 丽.卒中后偏瘫肩痛患者肩周组织超声影像特点[J].中国康复医学杂志,2019,(1):37~42
卒中后偏瘫肩痛患者肩周组织超声影像特点    点此下载全文
蔡桂元  贺涓涓  李 娜  李 鑫  窦祖林  解东风  陈嘉如  姜 丽
中山大学附属第三医院, 广州, 510630
基金项目:国家自然科学基金资助项目(81201508)
DOI:
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摘要:
      摘要 目的:本研究拟通过对脑卒中后偏瘫肩痛患者进行肩关节超声检查,观察卒中后偏瘫患者肩关节及其周围组织的超声影像特点,为偏瘫肩痛患者个体化临床治疗提供客观依据。 方法:2016年10月—2017年4月,随机纳入在中山大学附属第三医院康复科住院的31例偏瘫患者进行研究,根据NAS评分将所有患者分为肩痛组和非肩痛组,所有患者双侧肩关节均进行超声检查。体格检查包括肩关节被动关节活动度、Fugl-Meyer上肢功能评定、内收内旋肌群肌张力等。 结果:患者肩关节半脱位发生率:肩痛组高于非肩痛组(81.3% vs 40.0%,P=0.018)。肩痛组患者肩胛下肌-喙突滑囊粘连(81.3%)、肩峰下撞击征(75.0%)和肩峰-三角肌下滑囊病变(56.3%)的发生率均显著高于非肩痛组,组间差异有显著性意义(P<0.05)。 结论:本研究中,卒中后偏瘫肩痛患者的肩关节半脱位、肩胛下肌-喙突滑囊粘连、肩峰下撞击征及肩峰-三角肌下滑囊炎发生率显著高于非肩痛患者。超声影像可明确卒中后偏瘫肩痛患者肩关节及其周围软组织病变,有助于明确导致卒中后肩痛的可能原因,为卒中后肩痛患者的个体化临床治疗提供参考依据。
关键词:卒中  肩痛  肌骨超声
Sonographic characteristics in stroke patients with hemiplegic shoulder pain    Download Fulltext
The Third Affiliated Hospital of Sun-Yat Sen University, 510630
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Abstract:
      Abstract Objective: To observe the characteristics and pathological changes of shoulder sonograph in patients with hemiplegic shoulder pain after stroke, and to provide the basis for clinical treatment. Method: Thirty-one patients with hemiplegia were enrolled in the study. According to the NAS score, the patients were divided into 2 groups, shoulder-pain group and non-shoulder-pain group. Both shoulders of patients were examined by musculoskeletal sonography. Physical examination includes passive range of motion, Fugl-Meyer upper limb function assessment, adduction and internal rotation muscle tension. Result: The incidence of shoulder subluxation was significantly higher in the shoulder pain group than in the painless group (81.3% vs 40.0%). The incidence of subscapularis muscle-coracoid adhesions, subacromial impingement and acrominocular-deltoid bursa lesions were also higher in the shoulder-pain group than in the painless group (P<0.05). Conclusion: Incidences of shoulder subluxation, subscapularis muscle-coracoid adhesions, subacromial impingement and shoulder-deltoid bursitis in patients with stroke hemiplegic shoulder pain were higher than those painless (P<0.05).
Keywords:stroke  shoulder pain  musculoskeletal ultrasound
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