脑卒中肩痛患者肩部病变的研究

关键词：脑卒中  肩痛  超声检查

Keywords:stroke  shoulder pain  sonography

摘要：

      摘要 目的：通过超声检查分析脑卒中肩痛患者肩部病变的流行病学特点，研究脑卒中肩痛患者肩周肌力与肩部病变程度的相关性。 方法：超声检查脑卒中肩痛患者143例，根据患侧肩周肌力不同分为肩周肌力<3级组76例患者，肩周肌力≥3级组67例患者。 结果：脑卒中患者肩部软组织病变总的发生率为74.8%（n＝107），其中肩峰下-三角肌下滑囊积液或炎症的发生率最高，为41.3%（n＝59），肱二头肌长头腱肌腱炎、腱鞘积液或炎症的发生率为24.5%（n＝35），肩袖肌腱腱病的发生率为22.4%（n＝32），肩袖撕裂（部分撕裂或全层撕裂）的发生率为20.3%（n＝29）。脑卒中肩痛患者的肩部病变程度与其患侧肩周肌力之间无显著性意义上的相关性（P>0.05）。 结论：脑卒中肩痛患者的肩部病变发生率很高，其病变程度与患侧肩周肌力无关。早期及时了解脑卒中肩痛患者的肩部病变，并给予有效的治疗措施，有利于脑卒中患者上肢功能的康复。

Abstract:

      Abstract Objective：Using sonography to clarify the shoulder lesion and injury and to evaluate the relationship between sonographic findings and muscle strength of stroke patients with shoulder pain. Method：One hundred and forty three patients with shoulder pain were divided into two groups according to muscle strength of hemiplegic shoulder. Of which, 76 patients were in the muscle strength of hemiplegic shoulder below MMT grade 3 group and 67 patients were in the muscle strength of hemiplegic shoulder equal or above MMT grade 3 group. All the patients received ultrasound examination of their hemiplegic shoulders. Result：The total occurrence rate of shoulder lesion and injury was 74.8%（n＝107）.The occurrence rate of subacromial-subdeltoid bursal hydrops or bursitis was 41.3%（n＝59）. The occurrence rate of hydrops or inflammation of long head of biceps tendon sheath was 24.5%（n＝35）. The occurrence rate of tendinitis of rotator cuff was 22.4%（n＝32）. The occurrence rate of partial or complete tear of rotator cuff was 20.3%（n＝29）.There was no statistical correlation between muscle strength of hemiplegic shoulder and severity of shoulder lesion and injury（P>0.05）. Conclusion: The occurrence rate of shoulder lesion and injury after stroke was very high. There was no correlation between the severity of shoulder lesion and injury and the muscle strength of hemiplegic shoulder. For the function rehabilitation of upper extremity of stroke hemiplegic patients it is beneficial to find the shoulder lesion and injury earlier and administer effective therapy.