目的 探讨高频超声诊断卒中患者偏瘫侧肩关节病变,分析偏瘫侧肩痛的可能病因,为进一步治疗提供依据。方法 选择首次发病的卒中偏瘫患者93例,进行肩关节高频超声检查,分为肩痛组和无肩痛组,比较两组肩关节病变情况。同时应用改良Ashworth评分及Brunnstrom评分分别评定上肢肌张力及其运动功能。结果 93例中,超声发现异常 75例,占80.7%,主要病变包括肩袖损伤(25例),滑囊炎、滑囊积液(31例),肩关节半脱位(28例),肱二头肌长头腱及腱鞘病变(50例)。两组比较,在肩袖损伤,肩关节半脱位,滑囊炎、滑囊积液,肱二头肌长头腱及腱鞘积液的发病率上有统计学差异(χ2=8.67,P＜0.01; χ2=6.99,P<0.01; χ2=13.44,P＜0.01; χ2=3.87,P＜0.05),两组在年龄、性别、偏瘫侧、中风类型、病程、上肢肌张力和上肢运动功能评分等均无统计学差异。结论 高频超声可用于诊断卒中患者偏瘫侧肩关节的病变,为指导康复治疗提供依据。
Abstract
Objective To explore ultrasonographic characteristics of hemiplegic shoulders and investigate the cause of shoulder pain with high-resolution ultrasound.Methods A total of 93 patients who suffered from post-stroke hemiplegic shoulders for the first time underwent high frequency ultrasonography of shoulders. Subjects were assigned to shoulder pain group and without pain group. Variables were compared between patients with shoulder pain and those without. Modified Ashworth scores and Brunnstrom recovery stages were used to evaluate the muscle tone and motor function of the upper limb of patients.Results Seventy-five cases(80.7%)of abnormal ultrasound findings were found among the ninety-three stroke patients. The findings of ultrasound disclosed 25 cases of rotator cuff injury, 31 cases of bursitis and bursa effusion, 28 cases of shoulder subluxation and 50 cases of lesions of the long head of biceps tendon. There was significant difference in the incidence of the diseases mentioned above between the two groups (χ2=8.67,P<0.01; χ2=6.99,P<0.01; χ2=13.44,P<0.01; χ2=3.87,P<0.05). There was, however, no significant difference in the age, gender, side of hemiplegia, type and duration, upper limb muscle tone and motor function between these two groups.Conclusions High frequency ultrasound is a good means to test shoulder pain in patients with post-stroke hemiplegia. Sonographic findings provide data for the diagnosis and recovery of patients with hemiplegic shoulder pain.
关键词
卒中 /
偏瘫 /
肩痛 /
超声诊断
Key words
stroke /
hemiplegia /
shoulder pain /
ultrasound diagnosis
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参考文献
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