Efficacy Analysis Of Ultrasound-guided Joint Cavity Combined With Perishoulder Injection In The Treatment Of Hemiplegic Shoulder Pain

Objective:To retrospectively analyze the efficacy of ultrasound-guided joint cavity combined with perishoulder injection in treating hemiplegic shoulder pain.Methods:From October 2017 to August 2020,118 eligible patients with hemiplegic shoulder pain were selected from the inpatients in the department of rehabilitation medicine of our hospital.According to different injection schemes,they were divided into two groups:simple joint cavity injection group(group A,43 cases),Joint cavity combined with peri-shoulder injection group(group B,75 cases),of which group B is divided into three subgroups: joint cavity combined with subacromial bursa injection group(group B1,30patients),joint cavity combined with biceps brachii Long head tendon sheath injection group(B2 group,24 patients)and articular cavity combined coracoid subcapsular injection group(B3 group,21 patients).The visual analog pain score(VAS),upper limb motor function score(FMA-U),and ability of daily living(modified Barthel index,MBI)were used to compare shoulder pain and dysfunction before treatment,four weeks after treatment,and 12 weeks after treatment.Results:Patients in the two groups were followed up within 12 weeks,and the pain,dysfunction,and ability of daily living index were improved compared with baseline.(1)Comparison of AB groups: 4 weeks and 12 weeks after treatment,group B showed an overall advantage over group A in terms of pain,FMA and MBI score improvement(P<0.05).(2)Comparison of each subgroup between group A and group B: 4 weeks and12 weeks after treatment,compared with group A,groups B1 and B2 showed advantages in pain,FMA and MBI score improvement(P<0.05);after treatment At 4 weeks,there was no significant difference in pain score improvement between group B3 and group A(P>0.05).Group B3 showed efficacy advantages in terms of improvement in FMA and MBI scores(P<0.05);at 12 weeks after treatment,group B3 compared with Group A showed advantages in pain,FMA and MBI score improvement(P<0.05).(3)Comparison among the 3 subgroups of group B: 4 weeks after treatment,group B1 and group B2 were better than group B3 in terms of pain score improvement(P<0.05),and there was no statistical difference between the three groups in terms of improvement in FMA and MBI scores(P>0.05);12 weeks after treatment,there was no significant difference in the improvement of pain,FMA and MBI scores in the 3 subgroups of group B(P>0.05).Conclusion:1.Compared with simple joint cavity injection,joint cavity combined with shoulder injection can further reduce the pain of patients with hemiplegic shoulder pain,improve the patient’s shoulder joint function,and improve the ability of daily living.2.The overall curative effect of 2.3 combined treatments is better than that of shoulder joint cavity injection alone.Among them,compared with joint cavity combined with subacromial sac injection,joint cavity combined with subacromial sac injection and joint cavity combined with biceps long head tendon sheath injection have better curative effects in improving short-term pain,and can be used for patients with hemiplegic shoulder pain The preferred plan for combination therapy.